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Abstract Details

Risk of Psychosis among those with Parkinson’s disease with and without Minor Hallucinations
Movement Disorders
P6 - Poster Session 6 (5:30 PM-6:30 PM)
5-010
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.

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.

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.
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.
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. 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.
Taylor Myers Taylor Myers has nothing to disclose.
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.
Gregory Pontone Gregory Pontone has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Acadia Pharmaceuticals.
Catherine Victoria 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.