It is sometimes difficult to treat Parkinson disease because of severe hallucination and delusion. We report 4 cases of Parkinson disease that needed a treatment in the psychiatric ward by psychiatrist because of their severe psychotic symptoms. One case, suffering from depression with delusion and suicide attempt, was hospitalized into the open ward, and the other 3 cases, suffering from severe hallucination and delusion, were hospitalized into the closed ward. Psychotic symptoms improved in all cases. Motor function improved in 2 cases, and worsened in the other 2 cases. After psychotic symptoms had improved sufficiently, increase of L-dopa didn't induce psychosis. Once hallucination and delusion occur, medication is very difficult and psychosis does not improved immediately. Before those symptoms occur, we should be careful of psychosis.
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