Screening for Anxiety Symptoms in Parkinson Disease

Stefanova, Elka; Ziropadja, Ljubomir; Petrovic, M.; Stojković, Tanja; Kostić, Vladimir

doi:10.1177/0891988713476368

Cited by 31 publications

(46 citation statements)

References 37 publications

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“…Clinically significant depression may be present in 2.7% to 89% of PD patients (30) and a population-based study found an incidence rate among PD patients of nearly 26 cases per 1000 person-years, twice the incidence rate in the non-PD population (35). Anxiety risk in PD has been studied less extensively than depression, although many studies support a prevalence of 25–35% (31, 37, 43, 49–51), with some reporting a frequency as high as 50–70% (32, 52). Risk of depression and anxiety in PD may be affected by sex (32–34, 37), age at onset (32, 53), and disease duration (35, 49, 54).…”

Section: Discussionmentioning

confidence: 99%

“…In studies of IPD, female sex is sometimes reported as a risk factor for anxiety (32, 37, 43) and depression (33, 34, 36); in addition, among those with early, drug-naïve Parkinson disease, women may demonstrate higher rates of anxiety than men (59). It is of interest, then, that in our post-hoc analysis separating GBA-PD and IPD by sex, we found that men with GBA-PD had a greater burden of trait-anxiety and of depression than men with IPD, but that there was no difference between women with GBA-PD and women with IPD.…”

Section: Discussionmentioning

confidence: 99%

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Neuropsychiatric characteristics of GBA-associated Parkinson disease

Swan

Doan

Ortega

et al. 2016

Journal of the Neurological Sciences

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Mutations in GBA1 are a well-established risk factor for Parkinson disease (PD). GBA-associated PD (GBA-PD) may have a higher burden of nonmotor symptoms than idiopathic PD (IPD). We sought to characterize the relationship between GBA-PD and neuropsychiatric symptoms. Subjects were screened for common GBA1 mutations. GBA-PD (n=31) and non-carrier (IPD; n=55) scores were compared on the Unified Parkinson Disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), and the State-Trait Anxiety Index (STAI). In univariate comparisons, GBA-PD had a greater prevalence of depression (33.3%) versus IPD (13.2%) (p<0.05). In regression models controlling for age, sex, disease duration, motor disability, and MoCA score, GBA-PD had an increased odds of depression (OR 3.66, 95% CI 1.13–11.8) (p=0.03). Post-hoc analysis stratified by sex showed that, among men, GBA-PD had a higher burden of trait anxiety and depression than IPD; this finding was sustained in multivariate models. Among women, GBA-PD did not confer greater psychiatric morbidity than IPD. These results suggest that GBA1 mutations confer greater risk of neuropsychiatric morbidity in PD, and that sex may affect this association.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric characteristics of GBA-associated Parkinson disease

Swan

Doan

Ortega

et al. 2016

Journal of the Neurological Sciences

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“…A younger age of PD motor symptom onset is related to an increased risk of anxiety . Duration of PD diagnosis is positively correlated with anxiety in a number of studies . In contrast, Leentjens et al reported that longer disease duration is related to a reduction in anxiety disorders.…”

Section: Factors Associated With Anxiety In Pdmentioning

confidence: 99%

“…When restricted to individuals with clinically significant current anxiety disorders according to standardized criteria such as those of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD), or to individuals exceeding cutoff score thresholds on anxiety rating scales, the reported current prevalence rates in PD vary between 12.8% and 43.0% . Lifetime prevalence estimates are not included in the current review because of concerns about possible recall bias .…”

Section: Variable and High Prevalence Of Current Anxiety In Pdmentioning

confidence: 99%

“…A study focused on acute effects of levodopa ( l ‐dopa) suggested a strong correlation between plasma l ‐dopa levels and anxiety . Levodopa equivalent daily dosage was positively associated with anxiety in a limited number of studies . Leentjens et al reported that the use of l ‐dopa is the strongest marker for GAD in a logistic model of individual anxiety disorders.…”

Section: Factors Associated With Anxiety In Pdmentioning

confidence: 99%

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The clinical spectrum of anxiety in Parkinson's disease

et al. 2014

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Anxiety is common in Parkinson's disease (PD), and contributes to increased disability and poorer quality of life. In spite of its significant impact, the symptomatology, chronology, and neurobiology of anxiety in PD are all poorly understood, and this hinders accurate diagnosis and development of effective treatment strategies. This review investigates and updates literature related to the clinical spectrum of anxiety in PD. The reported prevalence of anxiety in PD varies considerably, with emerging interest in the frequency of the DSM-IV residual category of "Anxiety disorder, not otherwise specified" (Anxiety disorder NOS), which is observed in up to 25% of PD patients. By design, there are no standardized diagnostic criteria for Anxiety disorder NOS, because this is the category applied to individuals who do not meet diagnostic criteria for any other current anxiety disorder. Anxiety rating scales incompletely capture anxiety symptoms that relate specifically to PD symptoms and the complications arising from PD therapy. Consequently, these scales have been deemed inappropriate for use in PD, and there remains a need for the development of a new PD-specific anxiety scale. Research establishing accurate symptom profiles of anxiety in PD is sparse, although characterizing such symptomatology would likely improve clinical diagnosis and facilitate targeted treatment strategies. Research into the neurobiological and psychological underpinnings of anxiety in PD remains inconclusive. Anxiety can precede the onset of PD motor symptoms or can develop after a diagnosis of PD. Further investigations focused on the chronology of anxiety and its relationship to PD diagnosis are required.

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Characteristics and Treatment of Anxiety Disorders in Parkinson's Disease

Dissanayaka

White

O’Sullivan

et al. 2015

Movement Disord Clin Pract

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Background: Anxiety disorders are common in Parkinson's disease (PD) and are undertreated. The current study investigates demographic and PD-specific factors associated with Diagnostic and Statistical Manual (DSM-IV) anxiety disorders and subsyndromal anxiety in PD. It also examines the use of pharmacological and nonpharmacological treatments for anxiety in PD. Methods: Ninety nondemented PD patients completed a semistructured interview. Logistic regression models were constructed examining associations between several demographic, disease-specific, and treatment factors, as well as both current syndromal, DSM-IV anxiety disorders, and subsyndromal anxiety. Results: Associations were found between current DSM-IV anxiety disorder, as well as female gender, younger age, more severe stages of PD, and poor activities of daily living. Subsyndromal anxiety was related to a younger onset age of PD. Relationships were also found between both anxiety groups and more complications of PD therapy, as well as higher depression scores. There were no associations between anxiety and levodopa equivalent daily dosage, motor disability, and cognition. In our sample, 57% of patients with current DSM-IV anxiety disorders or subsyndromal anxiety were not currently treated with pharmacotherapy. Of those who currently received such treatment, 83% still experienced current anxiety disorders. Results suggest that anxiety is poorly recognized and treated in PD. Conclusions: Clinical trials investigating the efficacy of pharmacotherapy, tailored psychotherapy, and combination therapy primarily focusing on anxiety are much needed, with the aim of establishing novel targeted treatment protocols for the management of subtypes of anxiety disorders in PD.

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Screening for Anxiety Symptoms in Parkinson Disease

Abstract: Anxiety may be present as an isolated symptom, with specific demographic and clinical markers, and not only as a feature of depression in PD population. This highlighted the importance of identifying anxiety symptoms when treating patients with PD.

Cited by 31 publications

References 37 publications

Neuropsychiatric characteristics of GBA-associated Parkinson disease

Neuropsychiatric characteristics of GBA-associated Parkinson disease

The clinical spectrum of anxiety in Parkinson's disease

Characteristics and Treatment of Anxiety Disorders in Parkinson's Disease

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