Developing better tools to detect hallucinations in Parkinson’s disease

Abstract

This thesis focuses on the development of two patient-centred tools in Parkinson’s disease (PD), one especially for the early detection of hallucinations and psychosis. A cross-sectional study examined the relative importance of five issues regarding PD management for people living in Australia using a self-administered survey. Survey results showed that people with PD value research more highly than other direct forms of healthcare provision including access to PD nurses, multidisciplinary facilities with allied health professionals, subsidised treatments, and better general practitioner education. In a cohort study, PD patients (n = 197) and their caregivers (n = 163) were involved in validation procedures for the novel self-completed Psychosis and Hallucinations Questionnaire (PsycH-Q). PsycH-Q was found to have concurrent and convergent validity, internal consistency and inter-rater reliability when analogous items were compared with three other common questionnaire measures for assessing the presence of PD hallucinations. Patients indicated the highest prevalence of positive symptoms compared to the estimates of either their caregivers or clinicians, suggesting that the sole use of clinician-rated scales may underestimate the prevalence of PD hallucinations. In light of these findings, strategies for enhancing detection of hallucinations in PD should include self- and caregiver-report tools centred on the patient’s perspective.