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Open Access Research article

A questionnaire-based (UM-PDHQ) study of hallucinations in Parkinson's disease

Spiridon Papapetropoulos1*, Heather Katzen2, Anette Schrag3, Carlos Singer1, Blake K Scanlon2, Daniel Nation2, Alexandra Guevara1 and Bonnie Levin2

Author Affiliations

1 Divisions of Movement Disorders Department of Neurology, University of Miami, Miller School of Medicine Miami, FL, USA

2 Division of Neuropsychology Department of Neurology, University of Miami, Miller School of Medicine Miami, FL, USA

3 Department of Clinical Neurosciences, Royal Free and University College Medical School, University College London, London, UK

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BMC Neurology 2008, 8:21  doi:10.1186/1471-2377-8-21

Published: 20 June 2008

Abstract

Background

Hallucinations occur in 20–40% of PD patients and have been associated with unfavorable clinical outcomes (i.e., nursing home placement, increased mortality). Hallucinations, like other non-motor features of PD, are not well recognized in routine primary/secondary clinical practice. So far, there has been no instrument for uniform characterization of hallucinations in PD. To this end, we developed the University of Miami Parkinson's disease Hallucinations Questionnaire (UM-PDHQ) that allows comprehensive assessment of hallucinations in clinical or research settings.

Methods

The UM-PDHQ is composed of 6 quantitative and 14 qualitative items. For our study PD patients of all ages and in all stages of the disease were recruited over an 18-month period. The UPDRS, MMSE, and Beck Depression and Anxiety Inventories were used for comparisons.

Results and Discussion

Seventy consecutive PD patients were included in the analyses. Thirty-one (44.3%) were classified as hallucinators and 39 as non-hallucinators. No significant group differences were observed in terms of demographics, disease characteristics, stage, education, depressive/anxiety scores or cognitive functioning (MMSE) between hallucinators and non-hallucinators. Single mode hallucinations were reported in 20/31 (visual/14, auditory/4, olfactory/2) whereas multiple modalities were reported in 11/31 patients. The most common hallucinatory experience was a whole person followed by small animals, insects and reptiles.

Conclusion

Using the UM-PDHQ, we were able to define the key characteristics of hallucinations in PD in our cohort. Future directions include the validation of the quantitative part of the questionnaire than will serve as a rating scale for severity of hallucinations.