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Lewy bodies in psychiatric patients

This investigation concerns the mental changes associated with Lewy bodies. Lewy bodies are inclusion bodies found in nerve cells and are characteristic of idiopathic Parkinson's disease. It has also been suggested that they may occur as a normal ageing change. Previous literature concerning the psychiatric symptoms of Lewy body disease is reviewed. Dementia and parkinsonism‐associated depression have been previously recognized. For this study the psychiatric histories of two groups of autopsied mental hospital patients were compared; one group with Lewy bodies, and one group without Lewy bodies. There were 212 autopsies. Of these, 15 had Lewy bodies and 197 did not. Clinical and neuropathological descriptions of those with Lewy bodies are given. Findings are also presented in tabulated form, and the groups are compared statistically. Clinical diagnosis of Parkinson's disease and admission with a paranoid diagnosis were the findings most associated with Lewy bodies. It is suggested that paranoia may sometimes be an early symptom of Lewy body disease. The problem of patients with psychosis who subsequently develop idiopathic Parkinson's disease is discussed. Such patients could be misidentified and mistreated because of being diagnosed as drug‐induced parkinsonism.