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Parkinsonism Relat Disord. 2017 Oct;43:49-55. doi: 10.1016/j.parkreldis.2017.06.024. Epub 2017 Jul 5.

Predictors of anxiety in early-stage Parkinson's disease - Results from the first two years of a prospective cohort study.

Author information

1
Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands; Department of Anatomy & Neurosciences, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: s.rutten@vumc.nl.
2
Department of Epidemiology & Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands.
3
Section of Geriatric Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, United States.
4
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, United States.
5
Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands.
6
Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands.
7
Department of Anatomy & Neurosciences, VU University Medical Centre, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands.
8
Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands; Department of Anatomy & Neurosciences, VU University Medical Centre, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands.

Abstract

AIM:

Anxiety has a negative impact on daily functioning and quality of life in patients with Parkinson's disease (PD). This study aims at assessing which sociodemographic and clinical characteristics predict the course of anxiety in early PD.

METHODS:

The participants of this two-year prospective cohort study were recently diagnosed PD patients not receiving psychiatric medications or dopamine replacement therapy at baseline. Assessments were performed annually after baseline. The primary outcome measure was anxiety, as measured with the State-Trait Anxiety Inventory (STAI). Covariates were age, gender, family history, striatal dopamine transporter binding ratios, and severity of motor and non-motor features of PD at baseline. Data were analyzed using a mixed model analysis.

RESULTS:

Inclusion criteria were met by 306 subjects. An increase in STAI total score was predicted by older age, lower score on the Montreal Cognitive Assessment, and the presence of a probable REM-sleep behavior disorder (RBD) at baseline. A decrease in STAI total score over time was predicted by a higher baseline score on the 15-item Geriatric Depression Scale, compulsive behavior at baseline and a family history of PD.

CONCLUSIONS:

More severe baseline anxiety was associated with compulsive behavior and depressive symptoms. These symptoms had a parallel course, showing a decrease over time. An increase in anxiety was predicted by older age, worse cognitive functioning and the presence of RBD. Our findings, when replicated in a sample of PD patients in a more advanced disease stage, could provide starting points for prevention of anxiety in PD patients.

KEYWORDS:

Anxiety; Longitudinal; Neuropsychiatry; Parkinson's disease; Risk factor

PMID:
28711192
PMCID:
PMC5656500
DOI:
10.1016/j.parkreldis.2017.06.024
[Indexed for MEDLINE]
Free PMC Article

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