Consultation-liaison Approach for the Management of Psychiatric Manifestations in Parkinson's Disease and Related Disorders: A Report from Neuropsychiatric Hospital, India

BACKGROUND: Non-motor psychiatric manifestations of Parkinson's disease have been increasingly noted to contribute to morbidity and mortality. MATERIALS AND METHODS: We studied the psychiatric manifestations among inpatients with Parkinson's disease and other movement disorders by examining the referrals (N = 127) to consultation-liaison psychiatry services from neurology/neurosurgery between July 2009 and April 2010 using structured clinical proforma. RESULTS: Parkinson's disease and other movement disorders was the most common neurological diagnosis (19%). The most common reason for referral was depression (38%) followed by behavioral problems (33%). Post-assessment, depression rates were higher (54%) and behavioral manifestations were diagnosed as sleep problems (13%), organic psychiatric syndrome (13%), psychosis (8%), anxiety and obsessive compulsive disorder (8%), nil psychiatry (4%). CONCLUSION: Psychiatric comorbidity is high among in-patients with movement disorders and affective changes are common. Timely assessment using structured clinical proforma would help in enhanced detection of depression in patients with movement disorders.