Psychiatric and cognitive symptoms of Parkinson's disease: A life's tale

Rev Neurol (Paris). 2025 Apr;181(4):265-283. doi: 10.1016/j.neurol.2024.11.004. Epub 2024 Dec 22.

Abstract

Introduction: Neuropsychiatric symptoms are highly prevalent in Parkinson's disease (PD) and significantly affect the quality of life of patients and their significant others. The aim of this work is to describe typical neuropsychiatric symptoms and their treatment.

Methods: This is a narrative opinion paper, illustrated by a fictional case report. The most common neuropsychiatric symptoms such as depressive symptoms, anxiety, apathy, psychotic symptoms, impulse control disorders, as well as cognitive impairment are discussed in the context of prodromal stage, early stage, fluctuations stage, post-surgical intervention, and late stage of PD.

Results: Multiple factors such as pathophysiology, dopaminergic medication, deep brain stimulation, personality traits and individual life circumstances influence neuropsychiatric symptoms. Since the complexity and causes of neuropsychiatric symptoms can change, management strategies have to be adapted and individualised throughout the disease trajectory.

Discussion: Recognising neuropsychiatric symptoms within the framework of the disease stage and identifying their potential causes is pivotal to provide adequate interventions.

Keywords: Behavioural changes; Neuropsychiatric symptoms; Non-motor symptoms; Parkinson's disease.

Publication types

  • Review

MeSH terms

  • Aged
  • Cognition Disorders* / diagnosis
  • Cognition Disorders* / etiology
  • Cognition Disorders* / psychology
  • Cognition Disorders* / therapy
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / psychology
  • Cognitive Dysfunction / therapy
  • Disruptive, Impulse Control, and Conduct Disorders / etiology
  • Female
  • Humans
  • Male
  • Mental Disorders* / diagnosis
  • Mental Disorders* / etiology
  • Mental Disorders* / psychology
  • Mental Disorders* / therapy
  • Middle Aged
  • Parkinson Disease* / complications
  • Parkinson Disease* / diagnosis
  • Parkinson Disease* / psychology
  • Parkinson Disease* / therapy
  • Quality of Life