A frequência de sintomas psicóticos em tipos de demência: uma revisão sistemática

Pessoa, Rebeca Mendes de Paula; Maximiano-Barreto, Madson Alan; Lambert, Letícia; Leite, Érica Dayanne Meireles; Chagas, Marcos Hortes Nisihara

doi:10.1590/1980-5764-DN-2022-0044

person Rebeca Mendes de Paula Pessoa

designed the systematic review, conducted the literature search, selected studies, and extracted data from the primary studies · all other authors assisted in resolving issues, wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript

schoolUniversidade de São Paulo, Departamento de Neurociências e do Comportamento, Ribeirão Preto SP, Brazil.schoolUniversidade Federal de São Carlos, Grupo de Estudos e Pesquisas em Saúde Mental, Cognição e Envelhecimento, São Carlos SP, Brazil.

0000-0003-0867-1821

person Madson Alan Maximiano-Barreto

designed the systematic review, conducted the literature search, selected studies, and extracted data from the primary studies · all other authors assisted in resolving issues

schoolUniversidade Federal de São Carlos, Grupo de Estudos e Pesquisas em Saúde Mental, Cognição e Envelhecimento, São Carlos SP, Brazil.

0000-0002-1314-9846

person Letícia Lambert

designed the systematic review, conducted the literature search, selected studies, and extracted data from the primary studies · all other authors assisted in resolving issues

schoolInstituto Bairral de Psiquiatria, Itapira SP, Brazil.

0000-0003-1742-8081

person Érica Dayanne Meireles Leite

designed the systematic review, conducted the literature search, selected studies, and extracted data from the primary studies · all other authors assisted in resolving issues

schoolUniversidade de São Paulo, Departamento de Neurociências e do Comportamento, Ribeirão Preto SP, Brazil.schoolUniversidade Federal de São Carlos, Grupo de Estudos e Pesquisas em Saúde Mental, Cognição e Envelhecimento, São Carlos SP, Brazil.

0000-0001-5618-2219

person Marcos Hortes Nisihara Chagas

designed the systematic review, conducted the literature search, selected studies, and extracted data from the primary studies · all other authors assisted in resolving issues, conducted the analysis

schoolUniversidade de São Paulo, Departamento de Neurociências e do Comportamento, Ribeirão Preto SP, Brazil.schoolUniversidade Federal de São Carlos, Grupo de Estudos e Pesquisas em Saúde Mental, Cognição e Envelhecimento, São Carlos SP, Brazil.schoolInstituto Bairral de Psiquiatria, Itapira SP, Brazil.

0000-0003-3752-7984

Correspondence: Madson A. Maximiano-Barreto; Email:
mmaximianopsi@gmail.com.

Disclosure: There is no conflict of interest to declare.

Study and Research Group on Mental Health, Cognition and Aging – ProViVe at the Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brasil.

Author	Etiology of dementia	Sample (n)	Frequency of psychosis (% of total sample)	Description of the symptoms (% of total sample)
Binetti et al.¹⁶	AD/VD	92 AD: 61 VD: 31	Delusions: AD: 46%; VD: 39% Misidentifications: AD: 37.7%; VD: 19%	Delusions: AD – Persecutory: 13%; Theft: 13%; Jealousy: 6% VD – Persecutory: 23%; Theft: 23%; Jealousy: 3%; Somatic: 3%
van de Beek et al.¹⁷	DLB	73	Delusion: 9.5 Hallucinations: 11%	Delusions: Paranoid: 2.7%; Capgras: 5.5%; Somatic: 1.4%; Guilt: 1.4% Hallucinations: Tactile: 4.1%; Olfactory: 7.3%; Auditory: 11%
Chiu and Chung¹⁸	AD	91	Delusions: 35.2%	Delusions: Theft: 27.5%; Persecutory: 15.4%; Not being home: 5.5%; Abandonment: 4.4%; Jealousy: 2.2%; Intruder: 2.2%; Media people in the house: 2.2%; Capgras: 1.1%
Cohen-Mansfield et al.¹⁹	AD	74	Delusions: 46%	Delusions: Theft: 22%; Persecutory: 9%/Not being home: 7%; Abandonment: 5%; Non-paranoid: 5%
Cummings et al.²⁰	AD/VD	45 AD: 30 VD: 15	Psychosis: AD: 46%; VD: 46% Hallucinations: AD: 3.3%; VD: 27%	Hallucinations: AD – Olfactory: 3.33% VD – Auditory: 13%; Visual: 20% Misidentifications: AD – Capgras: 7%; Phantom Boarder: 3.33% VD – Phantom Boarder: 7%
Deutsch et al.⁷	AD	170	Delusions: 43.5% Hallucinations: 23.5% Misidentifications: 30%	Delusions: Persecutory: 32%; Reference: 6%; Jealousy: 4%; Grandeur: 0.6; Somatic: 0.6% Hallucinations: Visual: 20%; Olfactory: 11%; Tactile: 0.6% Misidentifications: Not being home: 15%; Phantom Boarder: 9%; Mirror: 6%; Capgras (caregiver): 0.6%
Devenney et al.²¹	FTD-BV FTD-ALS	Total: 79 Dementia: 56 FTD-BV: 36 FTD-ALS: 20	Psychosis: 34% Delusions: 28.57% Hallucinations: 25%	Delusions: Persecutory: 18%; Somatic: 9%; Grandeur: 7%; Jealousy: 5% Hallucinations: Auditory: 9%; Visual: 9%; Tactile: 4%
Farber et al.²²	AD	109	Psychosis: 63% Delusions: 60% Hallucinations: 32% (isolated: 4%) Misidentifications: 31% (84% with another psychosis)	Delusions: Persecutory: 37%; Jealousy: 3%; Others: 33% Hallucinations: Visual: 25%; Olfactory: 13%; Others: 6% Misidentifications: Other people: 23%; Person himself/herself: 5%; Television: 2%
Flynn et al.²³	AD/VD	33 AD: 19 VD: 14	Delusions: Total: 60.6% AD: 68.4% VD: 50%	Delusions: AD – Theft: 58%; Not being home: 47%; Persecutory: 37%; Capgras: 37% Abandonment: 37%; Jealousy: 26%; Phantom Boarder: 21% VD – Theft: 21%; Not being home: 14%; Jealousy: 14%; Phantom Boarder: 14%; Capgras: 7%; Abandonment: 7%
Förstl et al.²⁴	AD	56	Delusions: 16% Misidentifications: 25%	Delusions: Persecutory: 7%; Jealousy: 4%; Theft: 2%; Poisoning: 2%; Nihilist: 2% Hallucinations: Auditory: 12.5%; Visual: 17.8% Misidentifications: Capgras: 16%; Phantom Boarder: 9%; Television: 4%; Mirror: 4%
Geroldi et al.²⁵	AD	41	Delusions: 46%	Delusions: Theft: 46%; Persecutory or jealousy: 15%
Gormley and Rizwan²⁶	AD	70	Psychosis: 36% Delusions: 34% Hallucinations: 11%	Delusions: Persecutory: 21%; Theft: 14%; Jealousy: 11%; Abandonment: 7%; Capgras (caregiver): 4%; Not being home: 6%; Others: 6% Hallucinations: Visual: 7%; Auditory: 4%
Hamuro et al.²⁷	AD	202	Delusions: 29.7% Hallucinations: 8.42% Misidentifications: 21.8%	Delusions: Insult: 26%; Theft: 21%; Jealousy: 2%; Poisoning: 1.4%; Persecutory: 0.5%; Observation: 0.5%; Others: 3% Hallucinations: Visual: 7.43%; Auditory: 2.97% Misidentifications: Phantom Boarder: 20%; Capgras: 1.4%; Mirror: 0.5%
Harciarek and Kertesz²⁸	AD, FTD-BV, PPA, SD, CBD, PSP, PD, DLB	PPA: 60 SD: 17 PSP: 13 DLB: 36 PD: 9	Misidentifications: AD: 15.8% DLB: 16.3% SD: 8.3%	AD – Capgras: 5.9%; Capgras + Phantom Boarder or environment reduplication: 7.4%; Phantom Boarder or environment reduplication: 1.5% DLB – Capgras alone: 8.3%; Capgras + Phantom Boarder: 8.3% SD – Capgras: 2%; Capgras + Phantom Boarder/reduplication of place: 2% No relationship between MIs and FTD-BV, PPA, PSP, PD.
Ikeda et al.²⁹	AD	112	Delusions: 47.3% Misidentifications: 23%	Delusions: Theft: 75.5%; Persecutory: 9%; Abandonment: 2%; Jealousy: 5%; Others: 9% Misidentifications: Phantom Boarder: 14%; Not being home: 4%; Television: 4%/Capgras: 1%
Korhonen et al.³⁰	AD/FTD-BV	83 AD 75 FTD-BV	Delusions: AD: 4.8% FTD-BV: 34.67% Hallucinations: AD: 4.8% FTD-BV: 16%	AD – Auditory: 1.2%; Visual: 3.6% FTD – Auditory: 8%; Visual: 13.3%
Kwak et al.³¹	AD	230	Delusions: 27.4% Misidentifications: 5.2%	Delusions: Theft: 15%; Jealousy: 5%; Persecutory: 4%; Abandonment: 4%; Erotic: 0.4%; Grandeur: 0.4%; Mixed: 5% Misidentifications: Capgras: 4%; Phantom Boarder: 3%; Reduplication of place: 3%; Television: 2%; Mirror: 1%
Leroi et al.³²	AD/VD	260	Psychosis: AD: 26.9%/VD: 15.3% Delusions: AD: 21.8%/VD: 12.5% Hallucinations: AD: 12.8%/VD: 15.5% Misidentifications: AD: 8%/VD: 6.8%	Delusions: AD – Persecutory: 6.6%; Theft: 12.7%; Jealousy: 2.2%; Abandonment: 4.1%; Phantom Boarder: 4.6%; Capgras: 1.6%; Not being home: 3.1%; Media people in the house: 2% VD – Theft: 6.8%; Abandonment: 3.4%; Phantom Boarder: 5.1%; Capgras: 5.1%; Not being home: 3.4%; Media people in the house: 1.7% Hallucinations: AD – Auditory: 3.6%; Visual: 9.1%; Tactile: 1%; Gustatory: 0.5% VD – Auditory: 6.9%; Visual: 8.5%
Linszen et al.³³	AD	1,227	Delusions: 2% Hallucinations: 4.5%	Delusions: Theft: 22%; Capgras: 0.8%; Persecutory: 0.7% Hallucinations: Visual: 3%; Auditory: 1%; Olfactory: 0.4%; Tactile: 0.2%; Not specified: 1%
Liu et al.³⁴	AD	142	Delusions: 50.7% Hallucinations: 24.6%	Delusions: Theft: 30.3%; Persecutory: 29.6%; Not being home: 14.7%; Capgras (caregiver): 3.5%; Abandonment: 4.2%; Jealousy: 4.2%; Others: 1.4% Hallucinations: Visual: 21.1%; Auditory: 12%; Olfactory: 0.7%; Tactile: 0.7%
Mendez et al.³⁵,³⁶	AD	217	Delusions: 30% Hallucinations: 25.4% Misidentifications: 25.4%	Delusions: Theft: 11%; The other is dead: 5.5%; Persecutory: 5.5%; Jealousy: 2.5%; Somatic: 2%; Intrusion: 1.3%; Duplicate residence: 0.5%; Abandonment: 0.5% Hallucinations: Visual: 19%; Auditory: 3%; Tactile: 1%; Auditory+Visual: 3% Misidentifications: Capgras: 5%; Phantom Boarder: 5%; Mirror: 2.3%; Prosopagnosia: 1.4%; Television: 0.5%; Double subjective autoscopy: 0.5%
Mendez et al.⁶	AD/FTD	AD: 23 FTD: 86	Delusions AD: 17.4%/FTD: 2.3% Hallucinations AD: 21.7%/FTD: 3.48%	Delusions: AD – Delusions of jealousy: 17.4% FTD – Delusions of having been married to famous people and that her husband treated her badly; 1% with paranoid delusion
Migliorelli et al.³⁷	AD	103	Delusional disorder: 20% Hallucinations: 3%	Delusions: Theft: 14%; Hypochondriac: 14%; Abandonment: 7%; Not being home: 6%; Capgras: 6%; Grandeur: 6%; Jealousy: 4%; Erotomania: 2%
Mizrahi et al.³⁸	AD	771	Delusions: 32% Hallucinations: 7%	Delusions: Theft: 22%; Grandeur: 11%; Not being home: 9%; Abandonment: 6%; Jealousy: 6%; Capgras: 4%; Erotomania: 3%; Phantom Boarder: 1% Hallucinations: Visual: 4.2%; Auditory+Visual: 2%; Auditory: 1%; Tactile: 0.4%; Olfactory: 0.1%
Nagahama et al.¹¹	DLB	100	Delusions: 25% Hallucinations: 78% Misidentifications: 56%	Delusions: Theft: 14%; Persecutory: 11%; Hypochondriac: 3%; Jealousy: 1%; Pregnancy: 1% Hallucinations: Auditory: 8%; Tactile: 2% Misidentifications: People: 17%; Objects: 14%; Places: 28%; Phantom Boarder: 11%; Reduplication of people: 10%; Reduplication of places: 6%; Capgras: 6%; Television: 3%
Nagahama et al.³⁹	AD/DLB	AD: 200 DLB: 200	–	Persecutory delusions: AD: 55%; DLB: 65.5% Visual hallucinations: AD: 0%; DLB: 86.5% Auditory hallucinations: AD: 8%; DLB: 87.5% MI of people AD: 11.5%; DLB: 25% Television sign: AD: 1.5%; DLB: 4% Mirror sign: AD: 3%; DLB: 4.5%
Nedelec-Ciceri et al.⁹	AD	98	Misidentifications: 81.6%	Misidentifications: MI of people: 62% (Capgras: 1%) MI of places: 81% MI of self-identification: 14% (mirror 10%)
Naasan et al.⁴⁰	AD DLB FTD	AD: 111 DLB: 59 FTD: 201	Delusions: AD: 16.2% DLB: 25.4% FTD: 18.4% Hallucinations: AD: 12.6% DLB: 47.5% FTD: 18.1% Psychosis: AD: 22.5% DLB: 56.0% FTD: 20.1%	Delusions: AD – Paranoid: 9.0%; Persecutory: 1.8%; Intrusion: 0.9%; Hurting: 0.9%; Jealousy: 11.1%; Place: 3.0%; Other person: 11.1%; Grandeur: 1.8% DLB – Paranoid: 18.6%; Persecutory: 13.6%; Intrusion: 5.1%; Theft: 3.4%; Hurting: 5.0%; Jealousy: 8.5%; Place: 10.2%; Other person: 14.1%; Grandeur: 8.5% FTD – Paranoid: 11.9%; Persecutory: 7.5%; Intrusion: 2.5%; Theft: 3.1%; Hurting: 3.0%; Jealousy: 7.5%; Place: 1.5%; Other person: 2.5%; Grandeur: 7.5%; Erotomania: 2.5% Hallucinations: AD – Visual: 3.6%; Other hallucinations: 13.5% DLB – Tactile: 3.4%; Olfactory: 1.7%; Visual: 13.5%; Other hallucinations: 47.5% FTD – Tactile: 0.5; Olfactory: 0.5%; Visual: 1.5%; Other hallucinations: 18.1%
Perini et al.⁴¹	AD/VD/FTD/DLB	186 AD: 146 VD: 13 FTD: 6 DLB: 21	Misidentifications: 33.3-36% AD: 30.1% VD: 46.1% DLB: 57.1% FTD: 0	AD/DLB/VD MI of the house: 28.1/47.6/38.5% Capgras (people): 3.4/33.3/30.8% Capgras (objects/animals): 4.1/9.5/15.4% Fregoli: 0.7/9.5/7.7% Reduplicative Paramnesia: 7.5/23.8/15.4% Intermetamorphosis: 1.4/14.3/15.4% Syndrome of double subjects: 0/4.8%/0 MI of mirror: 4.8%/0/0 Division of people: 8.9/19/15.4% Television: 6.2/19/7.7% Cotard: 0.7%/0/0
Sala et al.⁴²	AD	180	Psychosis: 35.5% Delusions: 18.3% Hallucinations: 24% Misidentifications: 11.1%	Delusions: Theft: 11%; Persecution: 6%; Jealousy: 2% Hallucinations: Visual: 21%; Auditory+Visual: 2%; Auditory: 2% Misidentifications: Television: 8%; Phantom Boarder: 2%; Mirror: 1%
Suárez-González et al.⁴³	AD/DLB	165 AD: 85 DLB: 80	Delusions AD: 32.9%/DLB: 47.5% Hallucinations AD: 12.9%/DLB: 51.2% Misidentifications: AD: 17.6%/DLB: 42.5%	Delusions (AD/DLB): Paranoid: 20/23.7% Abandonment: 2.3/6.2% Somatic: 0/5% Hallucinations (AD/DLB): Visual: 12.9/50%; Auditory: 1.2/17.5%; Tactile: 0/3.7%; Olfactory: 0/3.7% Misidentifications (AD/DLB): Capgras: 9.4/22.5%; Phantom Boarder: 4.7/22.5%; Not being home: 7.1/31.2%; Television: 3.5/13.7%; Mirror: 1.2/2.5%
Tsunomoda et al.⁴⁴	DLB	124	Delusions: 54.8% Hallucinations: 63.7% Misidentifications: 13.7%	Delusions: Theft: 25.8%; Persecutory: 14.5%; Jealousy: 6.5%; Abandonment: 4% Hallucinations: Visual: 60.5%; Auditory: 35.5%; Auditory+Visual: 32.3% Misidentifications: Phantom Boarder: 31.4%; Not being home: 13.7%; Television: 12.1%; Capgras: 8.9%
Tzeng et al.⁴⁵	DLB	207	Delusions: 51.2%	Delusions: Theft: 35.3%; Persecutory: 21.3%; Not being home: 10.8%; Jealousy: 7.2%; Abandonment: 4.8% Misidentifications: Phantom Boarder: 2.9%; Media people in the house: 2.9%; Capgras: 1%
Wilson et al.⁵	AD	478	Delusions: 27.3% Hallucinations: 29.6% Misidentifications: 25.5%	Hallucinations: Auditory+Visual: 14%; Visual: 11%; Auditory: 5%

Type of dementia	Psychotic symptoms (%)	Delusions (%)	Hallucinations (%)	Misidentifications (%)
Alzheimer’s disease	82	2–68.4	3–32	5.2–81.6
Dementia with Lewy bodies	71	9.5–54.8	11–79.5	13.7–57.1
Vascular dementia	60	12.5–50	15.5–27	6.8–46
Frontotemporal dementia	66	3–25	3–25	0

[T1FN1] AD: Alzheimer’s dementia; VD: vascular dementia; DLB: dementia with Lewy bodies; FTD: frontotemporal dementia; BV: behavioral variant; ALS: amyotrophic lateral sclerosis; PPA: primary progressive aphasia; SD: semantic dementia; CBD: corticobasal degeneration; PSP: progressive supranuclear palsy; PD: Parkinson’s disease; MIs: misidentifications.