Abstract
The Mind-Body Connection: Developing integrated Old Age Psychiatry and Care of the Elderly Medicine services for people with Parkinson’s Disease:
Service Development and Evaluation
Introduction
With approximately 17,300 new diagnoses per annum and the ageing population we are facing the ever-growing challenge of managing complexity in Parkinson’s disease (1). It is recognised that the neuropsychiatric symptoms of Parkinson’s disease are as common and at least as disabling as the motor symptoms (2). These symptoms remain under-recognised and under-treated and evidence suggests that they are frequently missed by non-psychiatric specialists (3). The complexities around the management of neuropsychiatric symptoms require specialist input and patients with Parkinson’s Disease can face barriers to accessing psychiatric services (4).
Method
We established a working group which met regularly, including old age liaison psychiatrists and movement disorder specialists from the medicine for older people service.
Appropriate patients were identified through triage of new outpatient referrals, from inpatient reviews and at fortnightly MDT meetings. Clinical outcomes were measured using the Clinical Global Impressions (CGI) scale measuring illness severity and improvement following clinic and MDT input.
Results
Between April 2024 and April 2025 MDT outcomes were recorded for 60 patients. This underestimates the true number discussed as records reviewed from this period were found to be incomplete.
Between November 2023- February 2025, 12 integrated clinics and 34 patients were reviewed. The mean CGI-S score of patients seen in the clinic was 5.7 indicating that the majority of patients attending clinic were considered to be markedly ill. Following attendance at the clinic and associated interventions, the mean CGI-I score of patients was 2.5 demonstrating that most patients saw some benefit to attending the clinic. There was no evidence of harm from attending the integrated service.
Conclusion
An integrated service appears to provide benefit to patients living with Parkinson’s disease and related movement disorders. The opportunity to discuss and jointly review Parkinson’s patients with neuropsychiatric complications is valued by healthcare professionals.
- NICE (2023). Parkinson’s Disease: How Common Is it? [online] NICE. Available at: https://cks.nice.org.uk/topics/parkinsons-disease/background-information/prevalence/. Accessed 10/07/2025.
- Weintraub D, Aarsland D, Biundo R, Dobkin R, Goldman J, Lewis S. Management of psychiatric and cognitive complications in Parkinson's disease. BMJ. 2022 Oct 24;379:e068718. doi: 10.1136/bmj-2021-068718. PMID: 36280256.
- Shulman LM, Taback RL, Rabinstein AA, Weiner WJ. Non-recognition of depression and other non-motor symptoms in Parkinson's disease. Parkinsonism & Related Disorders. 2002 Jan;8(3):193-197. DOI: 10.1016/s1353-8020(01)00015-3. PMID: 12039431.
- Dobkin RD, Rubino JT, Friedman J, Allen LA, Gara MA, Menza M. Barriers to mental health care utilization in Parkinson's disease. J Geriatr Psychiatry Neurol. 2013 Jun;26(2):105-16. doi: 10.1177/0891988713481269. Epub 2013 Apr 15. PMID: 23589410; PMCID: PMC3644337.
Comments
PD coordinated clinics
The integrated PD clinic is an excellent venture. I think the incorrect poster is assigned to this abstract, though?
Thanks Alison, I think this…
Thanks Alison, I think this has now been fixed. It was a problem with the file name. Hopefully you can now see the poster.
It remains a challenge from proving cost benefit to allow sustainability of the service.
Excellent idea
This is such a great idea, we are trying to do something similar in our trust. Funding is the issue, such a shame that your clinic has been withdrawn due to funding. At our trust we are planning to start with an MDT then look at adding a clinic.
Well done.