Screening, Diagnosis, and Management of Parkinson’s Disease Psychosis: Recommendations From an Expert Panel

INTRODUCTION: Hallucinations and delusions present with psychosis are debilitating non-motor symptoms of Parkinson’s disease, with a prevalence of up to 50–70% at some point during the course of the disease. Often patients and caregivers do not report the presence of hallucinations or delusions unless specifically questioned. A panel of experts in neurology and geriatric psychiatry convened to develop a simple screening tool and guidance on diagnosis and treatment of Parkinson’s disease psychosis (PDP). METHODS: The working group reviewed literature for existing PDP guidelines on diagnosis and management and identified gaps in recommendations. The group discussed and developed a screening tool and treatment guidance that addressed the gaps in existing methodology based on their clinical experience. RESULTS: The proposed screening tool consists of two parts: (1) a brief pre-visit screening portion to be completed by the patient and caregiver, and (2) a clinician portion to be completed via clinical interview of the patient and caregiver. If psychotic symptoms are present, an appropriate treatment plan is developed for PDP based on evaluation. CONCLUSIONS: This simple screening tool and treatment guidance offers a practical clinical approach for clinicians in the diagnosis and management of PDP.