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Patient and Informant Views on Visual Hallucinations in Parkinson Disease

Lookup NU author(s): Dr Alison Killen, Daniel Collerton, Professor David Burn, Professor Ian McKeith, Dr Urs Mosimann


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Objective: Visual hallucinations (VHs) are a very personal experience, and it is not clear whether information about them is best provided by informants or patients. Some patients may not share their hallucinatory experiences with caregivers to avoid distress or for fear of being labeled insane, and others do not have informants at all, which limits the use of informant-based questionnaires. The aim of this study was to compare patient and caregiver views about VHs in Parkinson disease (PD), using the North-East Visual Hallucinations Interview (NEVHI). Methods: Fifty-nine PD patient-informant pairs were included. PD patients and informants were interviewed separately about VHs using the NEVHI. Informants were additionally interviewed using the four-item version of the Neuropsychiatric Inventory. Inter-reliability and concurrent validity of the different measures were compared. Results: VHs were more commonly reported by patients than informants. The inter-rater agreement between NEVHI-patient and NEVHI-informant was moderate for complex VHs (Cohen's kappa = 0.44; 95% confidence interval [CI]: 0.13-0.75; t = 3.43, df = 58, p = 0.001) and feeling of presence (Cohen's kappa = 0.35; 95% CI: 0.00-0.70; t = 2.75, df = 58, p = 0.006), but agreement was poor for illusions (Cohen's kappa = 0.25; 95% CI: -0.07-0.57; t - 2.36, df - 58, p - 0.018) and passage hallucinations (Cohen's kappa = 0.16; 95% CI: -0.04-0.36; t = 2.26, df = 58, p = 0.024). Conclusion: When assessing VHs in PD patients, it is best to rely on patient information, because not all patients share the details of their hallucinations with their caregivers.

Publication metadata

Author(s): Urwyler P, Nef T, Muri RM, Killen A, Collerton D, Burn D, McKeith I, Mosimann UP

Publication type: Article

Publication status: Published

Journal: American Journal of Geriatric Psychiatry

Year: 2015

Volume: 23

Issue: 9

Pages: 970-976

Print publication date: 01/09/2015

Online publication date: 25/12/2014

Acceptance date: 30/12/2014

ISSN (print): 1064-7481

ISSN (electronic): 1545-7214

Publisher: Elesvier


DOI: 10.1016/j.jagp.2014.12.190


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