Anxiety and Depression in Patients with Parkinson's Disease

Abstract

Objective To investigate the prevalence and clinical correlates of anxiety and depression in patients with Parkinson's disease (PD) and to examine the relationship between anxiety and depression and the quality of life (QOL). Methods One hundred and seventeen patients with PD completed the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory Second Edition (BDI-II), Starkstein's Apathy Scale (AS) and QOL battery. Hoehn and Yahr (HY) staging, the Unified Parkinson's Disease Rating Scale (UPDRS) and the Mini-Mental State Examination (MMSE) were administered on the same day. Results Anxiety (STAI score ! 41 for men or ! 42 for women) was diagnosed in 55% of the patients and depression (BDI-II score ! 14) was diagnosed in 56% of the patients. Anxiety coexisted with depression in 41% of the patients, while depression without anxiety was observed in 15% of the patients and anxiety without depression was observed in 14% of the patients. The STAI score was found to be significantly correlated with the UPDRS (I, IVC) and AS scores, whereas the BDI-II score was found to correlate with the HY stage and the UPDRS (I, III, IVB, C) and AS scores. Both the STAI and BDI-II scores were found to negatively correlate with QOL. A multivariate analysis revealed that depression and anxiety are similarly associated with the PD specific QOL (PDQ-39), while motor severity, as judged by the HY stage and UPDRS III score, is not. Conclusion These findings indicate that recognizing anxiety and depression in patients with PD is important, since both conditions are commonly observed in patients with PD and are similarly associated with the QOL, independent of motor severity.

Risk Factors of Major Depressive Disorder in Parkinson’s Disease

“…5 Depression is one of the major health problems in patients with PD. 6,7,38,39 Although, PD primarily is a movement disorder, depression in PD is difficult task and the predictors are complex and debatable. 8,38 The true prevalence of depression in PD is difficult to determine because there are no standardized assessment tools designed to evaluate depressive symptoms in the context of this disease.…”

“…[23][24][25][26][27][28][29][30][31] Whereas a recent study reported that PD patients with depression were associated with different demographic and clinical factors. [38][39][40][41] These findings emphasize the need to study the factors associated with depression in this population. It is well studied in western population but data from Asia especially sub-continent is limited.…”

Prevalence, impact, and management of depression and anxiety in patients with Parkinson’s disease

“…Numerous studies have shown that depression and anxiety negatively impact selfreport of quality of life in PD, [5][6][7][8][9][10][11] more so than motor symptom severity. 7,9 One study found that depression has more than twice the impact of motor symptoms on overall health status in PD.…”

“…7,9 One study found that depression has more than twice the impact of motor symptoms on overall health status in PD. 12 Many studies report comparable effects of depression and anxiety on quality of life, but at least one suggested that anxiety may be the strongest predictor of quality of life in PD.…”

“…25,[34][35][36] Some studies have found associations between depression and rapid disease progression, 18,37,38 motor fluctuations, 39 severity of illness, 40 younger age of onset, 38,39,41 and right-sided motor asymmetry. [41][42][43] Although some studies show an association between disease severity and depression, 9 it should be noted that associations between disease severity and depression may relate to the overlap between somatic symptoms of PD and somatic depressive symptomology, often measured by self-report questionnaires like the Beck Depression Inventory. 44 Another recent study showed that a number of nonmotor factors most strongly predicted presence of depression in PD, including female sex, history of anxiety and/or depression, family history of depression, worse functioning on activities of daily living, and worse cognitive status.…”