Abstract Details

Title Risk of Psychosis among those with Parkinson’s disease with and without Minor Hallucinations

Topic Movement Disorders

Presentation(s) P6 - Poster Session 6 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-010

Objective

To determine the risk of incident psychosis over a one-year period in a large Parkinson’s disease (PD) cohort, comparing those with versus without minor hallucinations.

Background Minor hallucinations, which include illusions, passage phenomena, and feeling of presence, are common in PD and may represent a prodromal form of psychosis. Fox Insight is a large, community-based online PD cohort in which participants complete quarterly standardized questionnaires and may elect to complete additional questionnaires.

Design/Methods Fox Insight participants completed a novel patient-reported questionnaire assessing for minor hallucinations, major hallucinations, and delusions over the prior month. We excluded from our analyses those with baseline psychosis, defined as report of major hallucinations or delusions on our questionnaire or on the Non-Motor Symptoms Questionnaire (NMS Quest), or antipsychotic use. Based on the responses to our questionnaire, participants were classified as either PD-minor hallucinations or PD-no minor hallucinations. We determined the incidence of psychosis at one year, defined as a new positive response to the NMS Quest hallucinations and delusions question or new report of antipsychotic use.

Results A total of 35,509 with PD were invited to participate; over an 18-month period, 5,950 (17%) completed the questionnaire. We identified 1,052 with PD-minor hallucinations (18%; mean age 68.9±8.2 years, 53% male, mean years since diagnosis 6.2±4.9, PD medication use 95%) and 2,708 with PD-no minor hallucinations (46%; mean age 68.6±8.5 years, 52% male, mean years since diagnosis 5.9±4.8, PD medication use 94%). Median duration of follow-up was 1.0 (interquartile range 0.4-1.4) years. At one year, the incidence rate for psychosis per 100 person-years was 20.1 (95% CI: 17.2-23.0) for PD-minor hallucinations versus 5.1 (95% CI: 4.2-6.0) for PD-no minor hallucinations, with a relative risk of 3.9.

Conclusions In PD, minor hallucinations are associated with nearly 4 times the risk of incident psychosis over one year.

Authors/Disclosures
Ruth Schneider, MD, FAAN (University of Rochester) PRESENTER	Dr. Schneider has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Escape Bio. The institution of Dr. Schneider has received research support from The Michael J. Fox Foundation. The institution of Dr. Schneider has received research support from NIH. The institution of Dr. Schneider has received research support from Acadia Pharmaceuticals. The institution of Dr. Schneider has received research support from CHDI. The institution of Dr. Schneider has received research support from Biohaven Pharmaceuticals. The institution of Dr. Schneider has received research support from Parkinson Study Group. The institution of Dr. Schneider has received research support from The Michael J. Fox Foundation. The institution of Dr. Schneider has received research support from Bial. Dr. Schneider has received personal compensation in the range of $500-$4,999 for serving as a Telemedicine Evaluator with Parkinson's Foundation.
Peggy Auinger (University of Rochester)	Ms. Auinger has nothing to disclose.
	No disclosure on file
Kelly A. Mills, MD (Johns Hopkins University)	Dr. Mills has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Tilosia. The institution of Dr. Mills has received research support from NINDS. The institution of Dr. Mills has received research support from MJFF. The institution of Dr. Mills has received research support from GKC.
Roseanne D. Dobkin, PhD (Rutgers University)	Dr. Dobkin has nothing to disclose.
	No disclosure on file
Catherine V. Kulick, MD (The Hospital of the University of Pennsylvania, Department of Neurology)	Dr. Kulick has nothing to disclose.
Melissa J. Nirenberg, MD, PhD, FAAN	The institution of Dr. Nirenberg has received research support from Department of Veterans Affairs,. The institution of Dr. Nirenberg has received research support from National Institutes of Health. Dr. Nirenberg has received personal compensation in the range of $0-$499 for serving as a Grant Reviewer with Parkinson's Foundation.

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