Co-occurring psychiatric disorders in neurodegenerative diseases: An emerging mental health challenge

Neurodegenerative diseases have been understood by mental health practitioners as primarily neurological disorders. New evidence points to a far greater degree of co-occurrence of psychiatric disorders than was previously recognized, with important implications for assessment, treatment and education of mental health professionals. This presentation highlights complex attendant mental health disorders in Parkinson's disease (PD) as a good example of co-occurring neurodegenerative and mental health disorders. Depression, anxiety, psychosis and addictions can all co-occur in PD, with up to 60% of those with PD experiencing depression, and 40% having an anxiety disorder. Gambling, sexual and shopping addictions and other impulsive behaviors can be part of PD, resulting from either medication and/or surgical side effects. These psychiatric disorders and addictions range from mild to severe, with research showing significant impact on quality of life, motor functioning, and family caregiver burden.

With the incidence of PD expected to grow significantly as the population ages, undiagnosed and untreated mental health disorders pose potential future challenges. It is imperative that mental health clinicians have the latest knowledge about this co-occurrence to provide evidence based assessment and treatment which avoids the risk of misdiagnosis or inappropriate treatment.

The presentation provides an overview of research, done by National Parkinson Foundation Centers of Excellence and others, outlining neuropsychiatric aspects of PD. It offers specifics about reliable and valid psychiatric assessment tools developed for PD, including existing tools validated for PD, and initial evidence-based practice guidelines for mental health clinicians, now being developed in the NPF international scientific network.