Anxiety and self-perceived health status in Parkinson's disease |
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| Authors: | Pontone Gregory M Williams James R Anderson Karen E Chase Gary Goldstein Susanne R Grill Stephen Hirsch Elaina S Lehmann Susan Little John T Margolis Russell L Rabins Peter V Weiss Howard D Marsh Laura |
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| Institution: | a Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA;b Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;c Food & Drug Administration, Silver Spring, MD, USA;d Department of Psychiatry, University of Maryland Medical Center, Baltimore, MD, USA;e Department of Neurology, University of Maryland Medical Center, Baltimore, MD, USA;f Department of Health Evaluation Science, Pennsylvania State University, Hershey, PA (Posthumous), USA;g Parkinson’s and Movement Disorders Center of Maryland, Elkridge, MD, USA;h Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA;i Department of Psychiatry, Georgetown University School of Medicine, Washington, DC, USA;j Department of Neurology, Georgetown University School of Medicine, Washington, DC, USA;k Department of Neurology, Sinai Hospital, Baltimore, MD, USA;l Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA;m Department of Neurology, Baylor College of Medicine, Houston, TX, USA |
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| Abstract: | Both anxiety and depression are associated with lower self-perceived health status (HS) in persons with Parkinson's disease (PD). Given the high co-morbidity with depression and other non-motor symptoms, it is unclear whether anxiety disorders, in general, versus specific anxiety subtypes have an independent effect on HS in PD. To examine this question, comprehensive assessments of motor and non-motor symptoms from 249 subjects with idiopathic PD followed in three community-based movement disorders neurology practices were analyzed. HS was measured using the 8-item PD Questionnaire (PDQ-8). Psychiatric diagnoses were established by consensus using a panel of six psychiatrists with expertise in geriatric psychiatry and movement disorders. Stepwise multiple regression analyses were used, with the PDQ-8 score as the dependent variable, to identify independent predictors of HS among motor, psychiatric, and other non-motor variables. Among the anxiety disorders, only anxiety associated with motor fluctuations was an independent predictor of HS after accounting for co-morbid depression and other clinical features. In addition, depressive disorders were also an independent predictor of lower HS. Prevention or treatment of state-dependent anxiety may improve HS in persons with PD. |
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| Keywords: | Parkinson’ s disease Non-motor symptoms Anxiety Psychiatric disorders Quality of life Fluctuations |
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