{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T16:52:23Z","timestamp":1786812743873,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2021,10,12]]},"abstract":"<jats:p>Background: Many cases of dementia with Lewy bodies (DLB) present with various psychotic features, including hallucinations, depression, catatonia, and delusions before the onset of cognitive impairment. However, the characteristic features of these psychotic symptoms in prodromal DLB have not been sufficiently described. Objective: To clarify and describe the psychotic features of prodromal DLB before overt cognitive impairment. Methods: The authors analyzed the characteristic psychotic features of prodromal DLB in 21 subjects who developed severe psychotic symptoms without dementia and were diagnosed as DLB after the longitudinal observation period. They were then confirmed to have DLB through indicative and supportive biomarkers of scintigraphy. Results: The psychotic features included a wide variety of symptoms, but convergent to three principal categories: catatonia, delusions-hallucinations, and depression and\/or mania. Catatonia was observed in nine cases, five were delusional-hallucinatory, and seven were manic and\/or depressive. Seven of the 21 cases exhibited delirium during longitudinal observation. A psychotic state repeatedly appeared without any trigger in 20 of the 21 patients. All subjects developed cognitive impairment at 9.1\u00b14.6 (mean\u00b1SD) years after the initial appearance of psychotic symptoms, and subsequently diagnosed with DLB at 71.3\u00b16.1 (mean\u00b1SD) years. Conclusion: Elderly patients with psychotic symptoms, such as catatonia, delusion-hallucination, manic and\/or depressive features, and delirium without dementia, could indicate symptomatic psychosis or a prodromal stage of any neurocognitive disorder such as DLB. Therefore, further extensive workout (e.g., radioisotope neuroimaging) is required to avoid misdiagnosis.<\/jats:p>","DOI":"10.3233\/jad-210416","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T14:12:06Z","timestamp":1629814326000},"page":"1917-1927","source":"Crossref","is-referenced-by-count":34,"title":["Psychotic Features Among Patients in the Prodromal Stage of Dementia with Lewy Bodies During Longitudinal Observation"],"prefix":"10.1177","volume":"83","author":[{"given":"Kumiko","family":"Utsumi","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Sunagawa City Medical Center, Sunagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Fukatsu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Nishi Kumagaya Hospital, Kumagaya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Nishi Kumagaya Hospital, Kumagaya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Takamaru","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Otaru General Hospital, Otaru, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Yasumura","sequence":"additional","affiliation":[{"name":"Sapporo Sato Hospital, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-210416_ref1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1212\/WNL.0000000000004058","article-title":"Diagnosis and management of dementia with Lewy bodies: Fourth Consensus Report of the DLB Consortium","volume":"89","author":"McKeith","year":"2017","journal-title":"Neurology"},{"key":"10.3233\/JAD-210416_ref2","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1212\/WNL.0000000000009323","article-title":"Research criteria for the diagnosis of prodromal dementia with Lewy bodies","volume":"94","author":"McKeith","year":"2020","journal-title":"Neurology"},{"key":"10.3233\/JAD-210416_ref3","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/psyg.12586","article-title":"Characteristics of initial symptoms and symptoms at diagnosis in probable dementia with Lewy body disease: Incidence of symptoms and gender differences","volume":"20","author":"Utsumi","year":"2020","journal-title":"Psychogeriatrics"},{"key":"10.3233\/JAD-210416_ref4","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1177\/0891988716656083","article-title":"Revisiting DLB diagnosis: A consideration of prodromal DLB and of the diagnostic overlap with Alzheimer disease","volume":"29","author":"McKeith","year":"2016","journal-title":"J Geriatric Psychiatry Neurol"},{"key":"10.3233\/JAD-210416_ref5","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1007\/s00259-018-3976-5","article-title":"Japanese multicenter database of healthy controls for [123I]FP-CIT SPECT","volume":"45","author":"Matsuda","year":"2018","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"10.3233\/JAD-210416_ref6","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1136\/jnnp-2017-317398","article-title":"123I-MIBG myocardial scintigraphy for the diagnosis of DLB: A multicenter 3-year follow-up study","volume":"89","author":"Komatsu","year":"2018","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.3233\/JAD-210416_ref7","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/MNM.0b013e328013eb8b","article-title":"An easy Z-score imaging system for discrimination between very early Alzheimer\u2019s disease and controls using brain perfusion SPECT in a multicenter study","volume":"28","author":"Matsuda","year":"2007","journal-title":"Nucl Med Commun"},{"key":"10.3233\/JAD-210416_ref8","doi-asserted-by":"crossref","unstructured":"Poewe W , Wenning GK (2003) Atypical parkinsonism. 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