Therefore, using this database with a massive sample size our objective was to explore retrospectively the prevalence of PS before the diagnosis of PD in the Hungarian population. Recently, we demonstrated that incidence and prevalence rates of PD are considerably higher than previous reports in Hungary and the healthcare administrative database of the National Health Insurance Fund (NHIF), using the International Classification of Diseases 10 th revision (ICD-10), with proper case identification and certification methodology is appropriate to evaluate epidemiological features of PD in Hungary. The onset and characteristics of PS in drug naïve patients before the diagnosis of PD are still not well studied, further examination of patients in the premotor, untreated phase is needed to better understand PS which are linked to the disease pathology itself. We recently reviewed the literature on PS addressing the early, untreated stages of PD, with a focus on the premotor and early motor phases separately and found that the prevalence of PS is high even in the premotor/prodromal phase. To explore PS that are related to PD itself it is necessary to study the prodromal phase and untreated patients as antiparkinsonian drugs have the potential to influence cognition, affective, psychotic and impulsivity symptoms. Some PS, especially depression and anxiety recently became known predictive markers for PD with several prospective studies reporting diagnostic value. Psychiatric symptoms (PS) are some of the non-motor features which are common even in the prodromal, untreated phase of PD, may precede motor symptoms and have a major impact on the course of the disease, quality of life and caregivers. However, converging evidence from neuropathological, clinical, and imaging research suggests a definable prodromal phase where detectable non-motor features are major components. Parkinson’s disease (PD) is a gradual-onset multisystem neurodegenerative disorder, currently clinically defined by a set of classical motor signs.
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