[Clinical presentation and diagnosis of Parkinson's disease in patients with schizophrenia spectrum disorders].

Abstract

Objective: To study the features of the clinical picture and diagnosis of Parkinson's disease (PD) in patients with schizophrenia spectrum disorders (SSD).

Material and methods: The analysis of databases of four psychoneurological dispensaries in Moscow with the allocation of groups of patients with diagnoses of SSD (F20-F25 according to ICD-10) was carried out. Among these groups, a targeted search for patients with an established diagnosis of PD (G20) was conducted. Among this category of patients, the incidence of PD, the therapy taken, the premotor symptoms of PD and the parameters characterizing the features of the clinical picture and diagnosis of PD were analyzed.

Results: A total of 9124 patients with SSD were identified, among them 11 people diagnosed with PD, while the final incidence of PD was 0.1% (95% CI 0-0.2%). The average age at onset of SSD and PD was 33.18±8.72 years and 58.9±8.1 years, respectively. The average time between the appearance of the first signs of PD and the final diagnosis was 5.09±1.92 years. The most commonly used antipsychotic in the group of patients with PD was quetiapine (54.5%); clozapine and some typical antipsychotics were used less frequently. The most common premotor symptoms were apathy, depression, anxiety, constipation and orthostatic hypotension. Hyposmia and behavioral disorders in the REM sleep phase were less common.

Conclusion: The results confirm the difficulty of managing patients with comorbidity of PD and SSD. Psychiatrists should pay close attention to the features of motor symptoms in patients with SSD and carefully identify clinical signs that may indicate the presence of PD or other neurodegenerative diseases with parkinsonism.