Psychiatry and Parkinson’s disease

Staff Members at Cognitive Psychiatry of Chapel Hill

Earlier this month I participated in the National Parkinson Foundation* Allied Team Training, an educational program for health care professionals working with Parkinson’s disease (PD). I learned a great deal, here are a few important learning points:

Many people have signs and symptoms of PD years and years before seeking medical attention, and many are misdiagnosed.
Here are 10 early warning signs of PD : 1) tremor or shaking, 2) small handwriting, 3) loss of smell, 4) trouble sleeping, 5) trouble moving or walking, 6) constipation, 7) a soft or low voice, 8) masked face, 9) dizziness and fainting, 10) stooping or hunching over. If you notice these symptoms, you should see your primary care doctor and / or a neurologist to investigate further.

Anxiety and depression are extremely common in PD.
We do not know why, but anxiety and depression present commonly in PD in all stages of the disease. Some symptoms may be related to the difficulty adjusting to a new diagnosis or new functional limitations, but other symptoms seem to be related to the PD itself. In the early and middle stages of PD, psychotherapy and medications may be helpful for these symptoms; in the later stages psychotherapy may be less helpful due to cognitive limitations.

There is a wide spectrum of cognitive problems with PD.
While most people with PD develop some degree of cognitive impairment, sometimes it is so mild that it is barely noticeable. In later stages of PD, many will develop cognitive impairment which looks somewhat different from that seen in other types of dementia, like Alzheimer’s disease (AD). People with PD tend to have more problems with visuospatial processing and “executive functioning”, whereas people with AD tend to have more problems with short-term memory. Neuropsychological testing can be used in PD to help determine the characteristics and severity of cognitive impairment; this information can be helpful when making decisions about when/if to stop working or driving.


Live Mentally Healthy,
Cognitive Psychiatry of Chapel Hill