Psychosis is a uniquely disabling complication of several neurodegenerative diseases. In recent years it has emerged as the focus of an increasing number of clinical investigations, approached from both pathological and phenomenological perspectives in several disease-specific contexts. One might imagine an eventual paradigmatic conception of psychosis that explicates its mechanistic underpinnings across multiple diseases. This is likely to be overly simplistic, given the heterogeneous nature of the symptoms that are often classified under the heading of psychosis, as well as the complexity of networks involved in generating perceptions and beliefs that are not congruent with reality. Recent work has reinvigorated the dopamine hypothesis of psychosis in schizophrenia and bipolar affective disorder,
1but it seems to us unlikely that the forms of psychotic phenomena that appear in neurodegenerative disorders possess significant mechanistic or pathologic overlap with such Kraepelinian psychoses. Nonetheless, it is striking and certainly non-trivial that such fundamentally different organic disorders can produce ostensibly comparable disturbances of perception and belief.
- Jauhar S.
- Nour M.
- Veronese M.
- et al.
A test of the trans-diagnostic dopamine hypothesis of psychosis, using PET imaging in bipolar affective disorder and schizophrenia.
JAMA Psychiatry. 2017; 74: 1206-1213
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Published online: December 26, 2017
Accepted: November 14, 2017
Received: November 13, 2017
© 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Psychosis and Clinical Outcomes in Alzheimer Disease: A Longitudinal StudyThe American Journal of Geriatric PsychiatryVol. 26Issue 3
- PreviewPsychosis is a common feature of Alzheimer disease (AD).1–4 Approximately 40% of patients with AD experience psychotic symptoms at some point, with around 36% experiencing delusions and 18% experiencing hallucinations3 (for simplicity, we refer to both as "symptoms," though they may also be considered to be signs). These symptoms are associated with worse clinical outcomes. Patients with psychosis typically have worse cognitive and functional abilities relative to patients without psychotic symptoms and have a worse prognosis in the longer term.