6 patients had a history of psychiatric disorders and 10 patients had a family history of psychiatric disorders. 3 elderly patients older than 70 years also had OS. Othello syndrome was more common in men (45 patients) than in women (22 patients) and frequently occurred in middle-aged patients. Results Clinical Characteristics of 67 Patients We reviewed 67 patients who had PD with OS as shown in Tables 1– 3. We added a new case treated in our institution. We newly found five case reports, four case series ( 5– 11), and three studies ( 12– 14) in addition to our previous case series ( 15). The references from the reviewed articles were examined for any missed articles. The contents of publications in English were reviewed and appropriate articles were included. The following keywords were used: delusional jealousy, OS, psychosis, delusions, jealousy, and Parkinson. PubMed was searched for relevant publications. We focused on OS in PD and reviewed the clinical characteristics of this syndrome. Because OS has infrequently occurred in patients with PD, the characteristics of OS in PD remain unclear. OS is accompanied by irrational thoughts and emotions associated with unacceptable or extreme behavior. Othello syndrome (OS) is a type of paranoid delusional jealousy, characterized by the false absolute certainty of the infidelity of a partner, leading to preoccupation with a partner’s sexual unfaithfulness based on unfounded evidence ( 4). The most common symptoms in PD-related psychosis are visual hallucinations. Typically, psychosis occurs in the late stage of PD and psychotic disorders may be present from the early stages ( 3). More than 20% of all patients with PD are affected by psychosis ( 2). Psychosis is the most frequent cause of admission to a nursing home among patients with PD ( 1). ![]() Psychosis in Parkinson’s disease (PD) can severely interfere with the quality of life and care of patients. When clinicians encounter such patients, the withdrawal or reduction of dopamine agonists should be attempted, and if necessary, additional treatment with clozapine is recommended. OS is infrequent in patients with PD, but is likely to be easily detected because OS is commonly accompanied by persistent paranoid and sexual delusions. In most patients, OS disappeared or the severity of OS was reduced. The dose of the PD medication associated with OS was decreased or these drugs were withdrawn to facilitate the treatment of OS. OS was associated with PD medication in 25 of 26 patients, especially in patients, used the dopamine agonists. Persecutory or other paranoid delusions developed in 34 patients with OS. 42 of 47 patients had other psychiatric disorders in addition to OS, and 5 patients had isolated OS. At the onset of OS, cognition was preserved in most patients. Until the onset of OS, the duration of PD (range, 2–19.8 years) and the duration of treatment with PD medications (range, 2 months to 18.5 years) varied. ![]() OS was more common in men (45 patients) than in women (22 patients), and it frequently occurred in middle-aged patients. We reviewed 67 patients who had PD with OS. We reviewed the clinical characteristics of this syndrome in PD. Because OS has infrequently occurred in patients with Parkinson’s disease (PD), the characteristics of OS in PD remain unclear. Othello syndrome (OS) is a type of paranoid delusional jealousy, characterized by the false absolute certainty of the infidelity of a partner. ![]() Department of Neurology, Nara Medical University, Kashihara, Japan.
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