Depression and social phobia in essential tremor and Parkinson's disease

Smeltere, Ligita; Kuzņecovs, Vladimirs; Erts, Renārs

doi:10.1002/brb3.781

Cited by 39 publications

(34 citation statements)

References 28 publications

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“…Based on a score of above 8 on the KDS-II, demoralization was found to have a prevalence of 13.3% in ET in our cohort. Demoralization was not associated with tremor severity, similar to that which is seen in studies of depression in ET, [15][16][17][18][19][20][21] where tremor severity did not positively correlate with depression. 13 Rather, as expected, demoralization was associated with related constructs including high levels of subjective incompetence and low levels of resilience.…”

Section: Discussionsupporting

confidence: 81%

“…16 These data suggest that depressive symptoms may not be a mere consequence of tremor in ET, but rather a separable comorbid entity or a marker of a certain premorbid tendency. [15][16][17][18][19][20][21] Demoralization, another manifestation of psychological distress, has been well-described in various chronic illnesses, and is characterized by feelings of helplessness, hopelessness, a sense of bewilderment, and an inability to cope in stressful situations. [22][23][24][25] Though demoralization can be associated with depression, they are distinct psychological phenomena with independent prognostic implications.…”

Section: Introductionmentioning

confidence: 99%

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Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity

et al. 2019

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Objective.Essential tremor (ET) is associated with psychological difficulties, including anxiety and depression. Demoralization (feelings of helplessness, hopelessness, inability to cope), another manifestation of psychological distress, has yet to be investigated in ET. Our objectives are to (1) estimate the prevalence of demoralization in ET, (2) assess its clinical correlates, and (3) determine whether demoralization correlates with tremor severity.Methods.We administered the Kissane Demoralization Scale (KDS-II) and several psychosocial evaluations (ie, scales assessing subjective incompetence, resilience, and depression [eg, Geriatric Depression Scale]) to 60 ET subjects. Tremor was assessed with a disability score and total tremor score. KDS-II >8 indicated demoralization.Results.Among 60 ET subjects (mean age = 70.2 ± 6.8 years), the prevalence of demoralization was 13.3%, 95% confidence interval = 6.9–24.2%. Although there was overlap between demoralization and depression (10% of the sample meeting criteria for both), 54% of depressed subjects were not demoralized, and 25% of demoralized subjects were not depressed. Demoralization correlated with psychological factors, but demoralized subjects did not have significantly higher total tremor scores, tremor disability scores, or years with tremor.Conclusions.Demoralization has a prevalence of 13.3% in ET, similar to that in other chronic or terminal illnesses (eg, cancer 13–18%, Parkinson’s disease 18.1%, coronary heart disease 20%). Demoralization was not a function of increased tremor severity, suggesting that it is a separable construct, which could dictate how a patient copes with his/her disease. These data further our understanding of the psychological and psychosocial correlates of ET.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity

et al. 2019

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“…Depression and anxiety are significantly increased in patients with essential tremor compared with controls and can be similar to what is seen in Parkinson’s disease 606162. This is true in younger and older populations 63.…”

Section: Clinical Manifestationssupporting

confidence: 59%

Essential tremor: diagnosis and management

Shanker

2019

BMJ

117

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Essential tremor is one of the most common movement disorders in adults and can affect both children and adults. An updated consensus statement in 2018 redefined essential tremor as an isolated action tremor present in bilateral upper extremities for at least three years. Tremor may also be present in other locations, commonly the neck or the vocal cords. Patients with additional neurologic symptoms are now categorized as “essential tremor plus.” Additional clinical features associated with the condition include but are not limited to cognitive impairment, psychiatric disorders, and hearing loss. When treatment is needed, propranolol and primidone are considered first line treatments. Patients who are severely affected are often offered deep brain stimulation. Although the ventral intermediate nucleus of the thalamus is the traditional surgical target, the caudal zona incerta is also being studied as a possible superior alternative. Magnetic resonance imaging guided high intensity focused ultrasound is a newer surgical alternative that may be ideal for patients with substantial medical comorbidities. Current research explores novel oral treatments, chemodenervation, and noninvasive neuromodulation for treatment of essential tremor.

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“…Clinically, PD is characterized by a wide variety of motor symptoms (bradykinesia, rigidity, tremor, gait disturbances, and dystonia among others), and non-motor symptoms (including mood disorders, anosmia, rapid eye movement sleep behavior disorder (RBD), and autonomic dysfunction) 19–21. Some of these non-motor features such as mood disorders and RBD may also occur at a higher frequency in ET patients than controls (as will be discussed later) 22,23. Historically, the UK Brain Bank criteria have been most widely used in clinically diagnosing PD, defined as the presence of bradykinesia with at least one additional feature of muscular rigidity, 4–6 Hz rest tremor, or postural instability; and the absence of exclusionary features (including strokes with stepwise progression of parkinsonism, head injury, neuroleptic treatment at symptom onset, or atypical parkinsonism features), which would suggest an alternative diagnosis 24.…”

Section: Resultsmentioning

confidence: 99%