Critical issues of the biopsychosocial treatment of Parkinson’s disease

2015 ◽  
Vol 156 (12) ◽  
pp. 472-478 ◽  
Author(s):  
Péter Kincses ◽  
Norbert Kovács ◽  
Kázmér Karádi ◽  
János Kállai
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Health ◽  
Interdisciplinary Approach ◽  
Cognitive Status ◽  
Psychological Burden ◽  
Her Family ◽  
Critical Issues

This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson’s disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient’s quality of life. An interdisciplinary approach is best suited for mitigating these effects. Not only the patient but also his/her family and environment is seriously affected by the disease and its consequences. Treatment and rehabilitation options for increasing or maintaining the quality of life of the affected patients are diverse, and significantly depend on the features of the health care system. The authors believe that the following review emphasizing health psychological principles may contribute to the work of professionals working in clinical and rehabilitational fields and through them may increase the quality of life of patients and their family. Orv. Hetil., 2015, 156(12), 472–478.

scholarly journals Apathy-Related Symptoms Appear Early in Parkinson’s Disease

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 91
Author(s):  
Emmie Cohen ◽  
Allison A. Bay ◽  
Liang Ni ◽  
Madeleine E. Hackney
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Diagnosis ◽  
Disease Severity ◽  
Regression Models ◽  
Cognitive Status ◽  
Stage Of Disease

Background: Apathy, often-unrecognized in Parkinson’s Disease (PD), adversely impacts quality-of-life (QOL) and may increase with disease severity. Identifying apathy early can aid treatment and enhance prognoses. Whether feelings related to apathy (e.g., loss of pleasure) are present in mild PD and how apathy and related feelings increase with disease severity is unknown. Methods: 120 individuals (M age: 69.0 ± 8.2 y) with mild (stages 1–2, n = 71) and moderate (stages 2.5–4; n = 49) PD were assessed for apathy and apathy-related constructs including loss of pleasure, energy, interest in people or activities, and sex. Correlations were used to determine the association of apathy with apathy-related constructs. Regression models, adjusted for age, cognitive status, and transportation, compared groups for prevalence of apathy and apathy-related feelings. Results: Apathy-related constructs and apathy were significantly correlated. Apathy was present in one in five participants with mild PD and doubled in participants with moderate PD. Except for loss of energy, apathy-related constructs were observed in mild PD at a prevalence of 41% or greater. Strong associations were noted between all apathy-related constructs and greater disease severity. After adjustment for transportation status serving as a proxy for independence, stage of disease remained significant only for loss of pleasure and loss of energy. Conclusion: People with mild PD showed signs of apathy and apathy-related feelings. Loss of pleasure and energy are apathy-related feelings impacted by disease severity. Clinicians should consider evaluating for feelings related to apathy to enhance early diagnosis in individuals who might otherwise not exhibit psychopathology.

scholarly journals The use of vortioxetine for the correction of depression in Parkinson's disease: an example of clinical cases

2019 ◽  
Vol 11 (3) ◽  
pp. 78-82 ◽  
Author(s):  
I. V. Miliukhina
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Depressive Disorder ◽  
Cognitive Status ◽  
Dopaminergic Drugs ◽  
Insufficient Response ◽  
Advanced Stages ◽  
Clinical Cases

The prevalence of depression in Parkinson's disease (PD) amounts to as much as 90%. The paper describes patients at different ages and with different durations of PD in its early and advanced stages and with various types of depressive disorder.The described clinical cases show that depression substantially worsens quality of life in a patient with PD and makes it difficult to choose antiparkinsonian therapy. Depression remains unrecognized on average in half of patients, while only a quarter of patients with identified depression receive timely treatment with antidepressants. PD complicated by depression is characterized by a faster progression and more significantly impaired quality of life and cognitive status than PD without affective disorders. Patients with PD and depressive disorder are characterized by an insufficient response to standard doses of antiparkinsonian drugs, which often leads to an irrational increase in the dose of dopaminergic drugs and to the development of complications.Difficulties in choosing an antidepressant for PD are associated with the development of a complex multicomponent neurotransmitter imbalance in this disease. The prescription of multimodal antidepressants can solve this problem.It is necessary to timely detect and correct depression in patients with PD using the currently available drugs and nonpharmacological methods (psychotherapy and physical rehabilitation). 

scholarly journals Impact of subthreshold depression on health-related quality of life in patients with Parkinson’s disease based on cognitive status

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Aline Schönenberg ◽  
Hannah M. Zipprich ◽  
Ulrike Teschner ◽  
Julian Grosskreutz ◽  
Otto W. Witte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Multivariate Analysis ◽  
Cognitive Status ◽  
Inventory Level ◽  
Subthreshold Depression ◽  
The Impact ◽  
Moca Score

Abstract Background In patients with Parkinson’s disease (PD), depression has a strong impact on quality of life (QoL). However, little is known about the influence of subthreshold depression (STD) on QoL in PD patients. Methods A total of 230 hospitalized PD patients with normal and impaired cognitive status were included in this observational study. We collected the following data for analysis: Beck Depression Inventory level, Montreal Cognitive Assessment (MOCA) score, non-motor symptoms questionnaire score, PD questionnaire-39 (PDQ-39) score, Hoehn–Yahr stage, and Movement Disorder Society-sponsored revision of the unified PD rating scale III (MDS-UPDRS III) score. To study the impact of STD on the PDQ-39 summary index (SI) and its domains, we used multivariate analysis of variance and multivariate analysis of covariance. Results In this cohort, 80 (34.8%) patients had STD [44 (32.3%) with high MOCA score (> 21) and 36 (38.3%) with low MOCA score (< 21)]. In PDQ-39 SI, there was a significant effect on depression level. In patients with higher MOCA score, STD was associated with worse PDQ-39 domains emotional well-being and cognition, whereas in patients with lower MOCA score, STD had no significant effect on PDQ-39 SI or its subdomains. Conclusion In PD patients, QoL is significantly affected by STD, and thus, more attention in medical care should be focused on treating STD. However, the impact is only observable in PD patients with normal cognitive function. STD patients show more reduced QoL than non-depressed patients, indicating that STD should be treated as a transition zone between normal mood and depression.

scholarly journals Hypomimia in Parkinson's Disease: What Is It Telling Us?

2021 ◽  
Vol 11 ◽  
Author(s):  
Teresa Maycas-Cepeda ◽  
Pedro López-Ruiz ◽  
Cici Feliz-Feliz ◽  
Lidia Gómez-Vicente ◽  
Rocío García-Cobos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Cognitive Status ◽  
Blink Rate ◽  
Nonmotor Symptoms ◽  
Timed Tests

Introduction: Amimia is one of the most typical features of Parkinson's disease (PD). However, its significance and correlation with motor and nonmotor symptoms is unknown. The aim of this study is to evaluate the association between amimia and motor and nonmotor symptoms, including cognitive status, depression, and quality of life in PD patients. We also tested the blink rate as a potential tool for objectively measuring upper facial bradykinesia.Methods: We prospectively studied amimia in PD patients. Clinical evaluation was performed using the Unified Parkinson's Disease Rating Scale (UPDRS) and timed tests. Cognitive status, depression, and quality of life were assessed using the Parkinson's Disease Cognitive Rating Scale (PD-CRS), the 16-Item Quick Inventory of Depressive Symptomatology (QIDS-SR16), and the PDQ-39, respectively. Amimia was clinically evaluated according to item 19 of UPDRS III. Finally, we studied upper facial amimia by measuring resting blink frequency and blink rate during spontaneous conversation.Results: We included 75 patients. Amimia (item 19 UPDRS III) correlated with motor and total UPDRS (r: 0.529 and 0.551 Spearman), and its rigidity, distal bradykinesia, and motor axial subscores (r: 0.472; r: 0.252, and r: 0.508, respectively); Hoehn and Yahr scale (r: 0.392), timed tests, gait freezing, cognitive status (r: 0.29), and quality of life (r: 0.268) correlated with amimia. Blinking frequency correlated with amimia (measured with item 19 UPDRS), motor and total UPDRS.Conclusion: Amimia correlates with motor (especially axial symptoms) and cognitive situations in PD. Amimia could be a useful global marker of overall disease severity, including cognitive decline.

scholarly journals Relationships among Depression, Anxiety, Sleep, and Quality of Life in Patients with Parkinson’s Disease in Taiwan

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Jun-Yu Fan ◽  
Bao-Luen Chang ◽  
Yih-Ru Wu
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disturbances ◽  
Rating Scales ◽  
Rating Scale ◽  
Cognitive Status ◽  
Health Related Qol ◽  
Health Related

The aim of this study was to examine the relationships among depression, anxiety, sleep disturbances, Parkinson’s disease (PD) symptoms, PD medications, and health-related quality of life (QOL) and to identify the predictors of health-related QOL in PD patients. To do this, we administered a battery of questionnaires and rating scales (validated Chinese versions), including the Unified Parkinson’s Disease Rating Scale, 39-item Parkinson’s Disease Questionnaire, Parkinson’s Disease Sleep Scale-2, Beck Depression Inventory, and Beck Anxiety Inventory, to 134 patients with PD whose Minimental State Examination scores were ≥24. We found that patients who reported having poorer QOL had longer disease durations, more severe PD symptoms, higher Hoehn and Yahr stages, and higher levodopa dosages, as well as higher levels of anxiety and depression, more sleep disturbances, and poorer overall cognitive statuses. Among these variables, the cognitive status, dependency of activities of daily living, depression, and anxiety were identified as predictors of QOL in PD patients and were all significant and independent factors of poor QOL in PD patients. The clinicians should be aware of the effects of these factors on QOL and attempt to treat comorbid psychiatric conditions to improve the PD patients’ QOL.

scholarly journals Determinants of Quality of Life According to Cognitive Status in Parkinson’s Disease

2020 ◽  
Vol 12 ◽  
Author(s):  
Yun Fan ◽  
Xiaoniu Liang ◽  
Linlin Han ◽  
Yan Shen ◽  
Bo Shen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Status

scholarly journals Relationship between Motor and Nonmotor Symptoms and Quality of Life in Patients with Parkinson’s Disease

2021 ◽  
Vol 12 (1) ◽  
pp. 1-12
Author(s):  
Eduardo Candel-Parra ◽  
María Pilar Córcoles-Jiménez ◽  
Victoria Delicado-Useros ◽  
Antonio Hernández-Martínez ◽  
Milagros Molina-Alarcón
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Well Being ◽  
Cognitive Status ◽  
Bivariate Analysis ◽  
Nonmotor Symptoms ◽  
Global Quality ◽  
Global Quality Of Life

Background: Parkinson’s disease (PD) is a chronic neurodegenerative disease that implies a progressive and invalidating functional organic disorder, which continues to evolve till the end of life and causes different mental and physical alterations that influence the quality of life of those affected. Objective: To determine the relationship between motor and nonmotor symptoms and the quality of life of persons with PD. Methods: An analytic, descriptive, cross-sectional study was conducted with patients with different degrees of PD in the Albacete Health district. The estimated sample size required was 155 patients. The instruments used for data collection included a purpose-designed questionnaire and “Parkinson’s Disease Questionnaire” (PDQ-39), which measures eight dimensions and has a global index where a higher score indicates a worse quality of life. A descriptive and bivariate analysis was conducted (SPSS® IBM 24.0). Ethical aspects: informed consent and anonymized data. Results: A strong correlation was found between the number of motor and nonmotor symptoms and global health-related quality of life and the domains mobility, activities of daily living, emotional well-being, cognitive status, and pain (p < 0.05). Receiving pharmacological treatment and taking more than four medicines per day was significantly associated with a worse quality of life (p < 0.05). Patients who had undergone surgical treatment did not show better global quality of life (p = 0.076). Conclusions: All nonmotor symptoms and polypharmacy were significantly associated with a worse global quality of life.

scholarly journals Impact of Anxiety on Quality of Life in Parkinson's Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Kristine K. Hanna ◽  
Alice Cronin-Golomb
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Life Quality ◽  
Cognitive Status ◽  
Motor Disability ◽  
Related Quality ◽  
Health Related ◽  
The Impact

In Parkinson's disease (PD), both the patient and the health care provider look for ways to preserve the patient's quality of life. Many studies focus on the impact of depression and motor disability on poor life quality but neglect to examine the role of anxiety. We investigated the impact of anxiety and depression on health-related quality of life in PD, using the Parkinson's Disease Quality of Life measure (PDQ-39). Symptoms of anxiety, more than depression, cognitive status, or motor stage, significantly affected quality of life in 38 nondemented patients with mild-to-moderate motor disability. Stepwise regression analyses revealed that anxiety explained 29% of the variance in the PDQ-39 sum score, and depression explained 10% of the variance beyond that accounted for by anxiety. The findings suggest that primary management of anxiety as well as depression may be important to optimizing the quality of life of PD patients.

Sign in / Sign up

Export Citation Format

Share Document