Cognitive and psychiatric disturbances in Parkinson's disease

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Psychiatric symptoms and cognitive impairment occur in the majority of patients with Parkinson's disease and have important clinical consequences for the patient and caregivers, in addition to health-related costs. Dysphoria and anxiety, hallucinations, apathy and cognitive impairment are the most common symptoms. The etiology is heterogeneous and includes psychosocial, structural and chemical brain changes, and treatment-related factors. Consensus criteria for the diagnoses of psychosis, depression and dementia associated with Parkinson's disease are now available, and a number of rating scales and questionnaires have been validated for the evaluation of cognitive impairment and psychiatric symptoms in Parkinson's disease. Level I evidence is available for the treatment of dementia, depression and psychosis, but there is still a need for development of safer and more effective treatments.

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