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Tremor Other Hyperkinet Mov (N Y). 2017 Dec 18;7:526. doi: 10.7916/D8Q53WF0. eCollection 2017.

Psychological Suffering in Essential Tremor: A Study of Patients and Those Who Are Close to Them.

Author information

1
Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA.
2
Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA.
3
Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.
4
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
5
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
6
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
7
Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA.

Abstract

Background:

Although the motor and non-motor features of essential tremor (ET) have been characterized in detail, it is not known whether ET patients suffer psychologically and whether those who are close to them consider them to be suffering in this way.

Methods:

Fifty ET patients and 50 "close others" (COs), identified by patients "as someone who knows you well and sees you often" and who can "provide a different perspective on your well-being", reported their own depressive symptoms, daily stress, and perceptions of patient psychological suffering and patient overall suffering with validated scales. ET patients' tremor severity, duration, disability, cognition, and number of medications were also assessed.

Results:

ET patients reported levels of psychological suffering within the range documented in arthritis and dementia patients from previous studies, and COs perceived significantly more psychological suffering in patients than patients reported themselves. Regression models, controlling for tremor severity, duration, and disability revealed that patients' greater psychological suffering was associated with greater patient depression. The greater perceptions of COs of patient psychological and overall suffering were associated with greater CO depression and daily stress. Sensitivity analysis showed that patients' cognitive status or number of medications did not affect the results.

Discussion:

Multidisciplinary teams caring for ET patients should look beyond simple clinical ET indicators. They should be aware of patient experiences and perceptions of COs of psychological and overall suffering. This will help guide the development of evidence-based, supportive interventions that improve communication about the needs of ET patients and those who are close to them.

KEYWORDS:

Essential tremor; clinical; depression; non-motor; suffering

Conflict of interest statement

Funding: This study was funded by the National Institutes of Health: R01 NS086736. The funding body played no role in the design of the study or in the collection, analysis, or interpretation of data or in writing the manuscript. Conflicts of interest: The authors report no conflict of interest. Ethics Statement: This study was performed in accordance with the ethical standards detailed in the Declaration of Helsinki. The authors’ institutional ethics committee has approved this study and all patients have provided written informed consent.

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