Clinical Edge

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Enhanced Tool Improves Detection of Psychosis in PD

Parkinsonism Relat Disord; ePub 2018 Apr 4; Kulick, et al

The enhanced Scale for the Assessment of Positive Symptoms in PD (eSAPS-PD) can markedly improve detection of psychotic symptoms in PD, according to a recent study. Researchers conducted a cross-sectional analysis of 199 consecutive PD outpatients. After a routine clinical visit that included the Unified Parkinson's Disease Rating Scale (UPDRS) and Non-Motor Symptoms Questionnaire (NMS-Quest), subjects completed the eSAPS-PD, a structured clinical interview that included the standard SAPS-PD with additional prompts for delusions and olfactory, gustatory, and minor hallucinations. Based on the combined results of these assessments, subjects were categorized as having major psychotic symptoms, isolated minor psychotic symptoms, or no psychotic symptoms. Researchers found:

  • 58 subjects (29%) were identified with psychotic symptoms, including 28 (14%) with major psychotic symptoms and 30 (15%) with isolated minor psychotic symptoms.
  • Hallucinations were present in 56 subjects (28%); most commonly visual (24%, of which 21% were minor only), followed by olfactory (6%), tactile (4%), auditory (2%), and gustatory (1%).
  • The eSAPS-PD detected psychotic symptoms in more subjects (n=55, 28%) than all other assessments combined (clinical visit, UPDRS part 1, and NMS-Quest) (n=22, 11%).


Kulick CV, Montgomery KM, Nirenberg MJ. Comprehensive identification of delusions and olfactory, tactile, gustatory, and minor hallucinations in Parkinson's disease psychosis. [Published online ahead of print April 4, 2018]. Parkinsonism Relat Disord. doi:10.1016/j.parkreldis.2018.04.008.

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