Research Article Hypomania, Depression, Euthymia: New Evidence in Parkinson’s Disease Margherita Canesi, 1 Sara Lavolpe , 2 Viviana Cereda, 1,3 Alessandra Ranghetti, 1,3 Roberto Maestri, 4 Gianni Pezzoli, 3 and Maria Luisa Rusconi 2 1 Department of Parkinson’s Disease, Movement Disorders & Brain Injury Rehabilitation, ‘Moriggia-Pelascini’ Hospital-Gravedona ed Uniti, Como, Italy 2 Department of Human and Social Sciences, University of Bergamo, Italy 3 Parkinson Institute, ASST G.Pini-CTO, Milan, Italy 4 Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri, IRCCS Montescano, Montescano, Italy Correspondence should be addressed to Sara Lavolpe; sara.lavolpe.91@gmail.com Received 7 July 2020; Revised 26 September 2020; Accepted 16 November 2020; Published 27 November 2020 Academic Editor: Luigi Trojano Copyright © 2020 Margherita Canesi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The field related to mood disorders in Parkinson’s disease (PD) is fragmented. The aim of this cohort observational study was to evaluate whether the episodes of mood alteration could appear in different disease stages and to verify how nonmotor symptoms were led off into different stages. We enrolled 93 PD outpatients (three groups: drug naive—DN; not exhibiting motor fluctuations—n-MF; and exhibiting motor fluctuations—MF) and 50 healthy controls. Mood state was assessed through the Internal State Scale (ISS) while depressive symptoms were evaluated through the Beck Depression Inventory-II (BDI-II), nonmotor symptoms by means of the Non-Motor Symptoms Scale (NMSS), and the presence of impulse control disorders (ICDs) with the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP). Clinical and pharmacological data have also been recorded. No significant differences in mood state distribution between groups were observed. Nevertheless, as regards the mood state distribution within groups, in n-MF (47.6%) and MF patients (50%), (hypo)mania presence was significantly higher than other symptoms. In DN patients, hypomania showed a prevalence of 38.1% although it was not significant. At least one ICD was reported in 29.3% of n-MF and 50% of MF patients. In the MF group, a moderate positive correlation between ISS ACTivation subscale scores and the presence of ICDs and compulsive medication use emerged. Finally, MF patients reported higher BDI-II total scores than DN. Our results show that mood alterations in PD, considering both depressive symptoms and mood elevation, are related to the advanced stages of the disease as well as the presence of ICDs, and dopaminergic therapy would not always be able to restore a normal mood condition. 1. Introduction The study of mood disorders in Parkinson’s disease (PD) has mainly focused on depressive symptoms, which can emerge in different disease stages [1]. When these symptoms arise at advanced stages, they could be considered a consequence of the neuronal degeneration or a psychological reaction to the pathology per se, or both; moreover, the onset of depres- sion before any clinical sign of PD seems to be part of the neurodegenerative process that leads to dopaminergic neu- rons’ death [2]. Less common are the studies concerning mood elevation in PD patients, which seems to be underestimated. Some authors have reported cases of patients who showed behavioural changes, suggestive of mania, after deep brain stimulation (DBS) [3]. Since the 70’s, it has also been observed that L-dopa can induce (hypo)mania in patients with bipolar affective disorder or PD [4]. In general, there is evidence that neurotransmitter systems such as dopaminer- gic, serotoninergic, and noradrenergic are involved in bipolar Hindawi Behavioural Neurology Volume 2020, Article ID 5139237, 8 pages https://doi.org/10.1155/2020/5139237