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Few studies, however, have compared disease-related rates of psychosis prevalence in a large autopsy-based cohort, and it remains unclear how diseases differ with respect to the nature or content of the psychosis. We conducted a retrospective chart review of 372 patients with autopsy-confirmed neurodegenerative pathology: 111 with Alzheimer\u2019s disease, 59 with Lewy body disease and concomitant Alzheimer\u2019s disease, 133 with frontotemporal lobar degeneration (FTLD) with tau inclusions (including progressive supranuclear palsy, corticobasal degeneration or Pick\u2019s disease), and 69 with FTLD and TDP inclusions (FTLD-TDP, including types A\u2013C). Psychosis content was classified by subtype, and the frequency of each subtype was compared among pathological diagnoses using logistic regression. A total of 111 of 372 patients had psychosis. Compared to other groups, patients with Lewy body disease\/Alzheimer\u2019s disease pathology were significantly more likely to have hallucinations and were more likely to have more than one subtype of hallucination. Patients with Braak Parkinson stage 5\u20136 Lewy body disease were significantly more likely than those with no Lewy body disease to have visual hallucinations of misperception, peripheral hallucinations, hallucinations that moved, hallucinations of people\/animals\/objects, as well as delusions regarding a place and delusions of misidentification. The feeling of a presence occurred significantly more frequently in patients with Lewy body disease\/Alzheimer\u2019s disease than all other pathologies. Patients with FTLD-TDP were significantly more likely to have delusions, and for the delusions to occur in the first 3 years of the disease, when compared to patients with Alzheimer\u2019s disease and FTLD-tau, though rates were not significantly greater than patients with Lewy body disease\/Alzheimer\u2019s disease. Paranoia occurred more frequently in the FTLD-TDP and Lewy body disease\/Alzheimer\u2019s disease categories compared to patients with Alzheimer\u2019s disease or FTLD-tau. Patients with FTLD-TDP pathology had delusions of misidentification as frequently as patients with Lewy body disease\/Alzheimer\u2019s disease, and were significantly more likely to have self-elevating delusions such as grandiosity and erotomania compared to patients with other pathologies including FTLD-tau. These data show that the nature and content of psychosis can provide meaningful information about the underlying neurodegenerative pathology, emphasizing the importance of characterizing patients\u2019 psychoses for prediction of the neuropathological diagnosis, regardless of a patient\u2019s clinical syndrome.<\/jats:p>","DOI":"10.1093\/brain\/awaa413","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T12:10:52Z","timestamp":1605096652000},"page":"999-1012","source":"Crossref","is-referenced-by-count":122,"title":["Psychosis in neurodegenerative disease: differential patterns of hallucination and delusion symptoms"],"prefix":"10.1093","volume":"144","author":[{"given":"Georges","family":"Naasan","sequence":"first","affiliation":[{"name":"Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, 94158, USA"},{"name":"The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Department of Neurology, Icahn School of Medicine, Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M","family":"Shdo","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, 94158, USA"},{"name":"Department of Psychology, University of California Berkeley, Berkeley, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estrella Morenas","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Biomedizinisches Centrum (BMC), Biochemistry Chair, Ludwig-Maximilians-Universit\u00e4t and Deutsches Zentrum f\u00fcr Neurodegenerative Erkrankungen (DZNE), Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3570-9143","authenticated-orcid":false,"given":"Salvatore","family":"Spina","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W","family":"Seeley","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce L","family":"Miller","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine P","family":"Rankin","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, 94158, 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