Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis

BackgroundDepression and anxiety in Parkinson's disease are common and frequently co-morbid, with significant impact on health outcome. Nevertheless, management is complex and often suboptimal. The existence of clinical subtypes would support stratified approaches in both research and treatment.MethodFive hundred and thirteen patients with Parkinson's disease were assessed annually for up to 4 years. Latent transition analysis (LTA) was used to identify classes that may conform to clinically meaningful subgroups, transitions between those classes over time, and baseline clinical and demographic features that predict common trajectories.ResultsIn total, 64.1% of the sample remained in the study at year 4. LTA identified four classes, a ‘Psychologically healthy’ class (approximately 50%), and three classes associated with psychological distress: one with moderate anxiety alone (approximately 20%), and two with moderate levels of depression plus moderate or severe anxiety. Class membership tended to be stable across years, with only about 15% of individuals transitioning between the healthy class and one of the distress classes. Stable distress was predicted by higher baseline depression and psychiatric history and younger age of onset of Parkinson's disease. Those with younger age of onset were also more likely to become distressed over the course of the study.ConclusionsPsychopathology was characterized by relatively stable anxiety or anxious-depression over the 4-year period. Anxiety, with or without depression, appears to be the prominent psychopathological phenotype in Parkinson's disease suggesting a pressing need to understanding its mechanisms and improve management.

Download Full-text

Identifying Symptom Profiles of Depression and Anxiety in Patients with an Acute Coronary Syndrome Using Latent Class and Latent Transition Analysis

The International Journal of Psychiatry in Medicine ◽

10.2190/pm.42.2.g ◽

2011 ◽

Vol 42 (2) ◽

pp. 195-210 ◽

Cited By ~ 7

Author(s):

Mayra Tisminetzky ◽

Bethany C. Bray ◽

Ruben Miozzo ◽

Onesky Aupont ◽

Thomas J. McLaughlin

Keyword(s):

Acute Coronary Syndrome ◽

Latent Class ◽

Latent Transition Analysis ◽

Depression And Anxiety ◽

Transition Analysis ◽

Coronary Syndrome ◽

Symptom Profiles ◽

Latent Transition

Download Full-text

Involuntary Movements

10.1093/med/9780190609917.003.0032 ◽

2017 ◽

Author(s):

Chizoba Umeh

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Age Of Onset ◽

Treatment Options ◽

Female Gender ◽

Levodopa Dose ◽

Involuntary Movements ◽

Levodopa Treatment ◽

Younger Age ◽

Deep Brain

Choreiform involuntary movements, “dyskinesia,” are a manifestation of chronic levodopa treatment in Parkinson’s disease. Levodopa-induced chorea presents as brief, irregular, non-rhythmic, flowing, involuntary movements. Risk factors for levodopa- induced dyskinesia include younger age of onset of Parkinson’s disease, greater disease severity, higher levodopa dose, longer duration of levodopa treatment, and female gender. Patients can have varying frequency and severity of dyskinesia. Treatment options for patients with disabling dyskinesia include adjusting the levodopa dose and daily dosing schedule, amantadine, intraduodenal levodopa, and deep brain stimulation.In this chapter, a case of a 69-year-old woman with longstanding Parkinson’s disease on chronic levodopa treatment is discussed, including the disease course, differential diagnosis, workup, and treatment outcome.

Download Full-text

Depression and anxiety among patients with Parkinson’s disease: frequency, risk factors, and impact on quality of life

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00253-5 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Eman M. Khedr ◽

Ahmed A. Abdelrahman ◽

Yasser Elserogy ◽

Ahmed Fathi Zaki ◽

Ayman Gamea

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Age Of Onset ◽

Negative Impact ◽

Depression And Anxiety ◽

Yahr Scale ◽

History Of

Abstract Background Depression and anxiety are non-motor symptoms of Parkinson’s disease (PD) that are often overlooked and underrated. This study aimed to highlight the frequency and risk factors of depression and anxiety among subjects with PD. Methods Sixty-four patients with PD who were diagnosed according to United Kingdom Parkinson’s Disease Society (UKPDS) Brain Bank Criteria and 50 sex- and age-matched healthy control subjects are evaluated for depression and anxiety. PD severity and staging were assessed using Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr scale. Depression and anxiety were diagnosed using DSM-IV TR criteria and scored using Hamilton Depression and Hamilton Anxiety Rating Scales (HAM-D and HAM-A). The World Health Organization Quality of Life (WHOQOL)-BREF was used to assess impact of depression and anxiety on quality of life. Results 31.25% of patients with PD had depression while 40.6% of patients had anxiety disorder. Depression was higher in females and patients with history of depression and low socioeconomic status (SES). Anxiety was common in young patients and those who had history of anxiety. Overlap between depression and anxiety was recorded in 23.4%. Total UPDRS and Hoehn and Yahr scale accounted for 33.4% of variance for depression. Total UPDRS and earlier age of onset accounted for 39% of variance for anxiety. Advanced disease stage and severity were independent predictors for depression while disease severity and younger age of onset were the main predictors for anxiety. Depression and anxiety have a negative impact on the overall quality of life of PD patients especially on physical and psychosocial domains. Conclusion Depression and anxiety are relatively common in PD. Female gender, low SES, and history of depression were the main risk factors for developing depression. Young age and history of anxiety were risk factors for anxiety. Both had negative impact on quality of life.

Download Full-text