Odds of PD diagnosis significantly higher among those with psychotic-spectrum disorders

Key takeaways:

• Researchers analyzed 13,998 patients, including 3,501 with Parkinson’s disease.
• The odds of a PD diagnosis were 76% higher among those with a psychotic-spectrum disorder.

PHILADELPHIA — Patients with a psychotic-spectrum disorder may be more likely to develop Parkinson’s disease, especially if they have an additional diagnosis of anxiety, according to a poster presentation.

“A lot of patients we see may have psychotic-spectrum disorders, and often we see alterations in their movement, which may be medication-induced,” Anna Shvartsur, MD, a resident in the department of psychiatry at Kaiser Permanente Oakland Medical Center, told Healio at the American Neurological Association annual meeting. “[We were] trying to see whether there may be a connection between psychotic-spectrum disorders and Parkinson’s disease, although they work in different ways regarding dopamine activity.”

Shvartsur and colleagues examined the prevalence of psychotic-spectrum disorders before development of PD in a cohort of Kaiser Permanente members in northern California, as well as the prevalence of comorbid anxiety or depression before PD diagnosis.

Their retrospective, case-control study included 13,998 individuals (61.7% men; 42.5% aged 70 to 79 years), of whom 3,501 had a PD diagnosis (61.7% men; 41.9% aged 70 to 79 years) and 10,497 were controls (61.7% men; 42.7% aged 70 to 79 years) matched by sex, age, admission date and encounter facility.

Researchers identified mental health conditions by ICD-9 and ICD-10 diagnosis codes up to 5 years before matched case index date and utilized bivariate analyses to analyze associations between psychotic-spectrum disorders and PD. They also used multivariable analysis with conditional logistic regression to assess the relationship between mental health conditions and PD.

According to results, the odds of an eventual PD diagnosis were 76% higher among those with psychotic-spectrum disorders compared with controls. Additionally, among individuals with a psychotic-spectrum disorder, a diagnosis of anxiety was associated with 166% higher odds of developing PD. Conversely, an additional diagnosis of depression did not further increase those odds.

“In patients who have some sort of psychotic-spectrum disorder and may have an additional anxiety disorder, we should definitely think about whether they may be more likely to develop Parkinson’s disease and to make sure they can be assessed for it,” Shvartsur told Healio.