Martijn P G Broen1, Sebastian Köhler2, Anja J H Moonen3, Mark L Kuijf1, Kathy Dujardin4, Laura Marsh5, Irene H Richard6, Sergio E Starkstein7, Pablo Martinez-Martin8, Albert F G Leentjens2,3. 1. Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands. 2. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands. 3. Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands. 4. Neurology and Movement Disorders Unit, Lille University Medical Center, Lille, France. 5. Departments of Psychiatry and Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 6. Departments of Neurology and Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. 7. School of Psychiatry, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia, Australia. 8. Area of Applied Epidemiology, National Center for Epidemiology, and CIBERNED, Carlos III Institute of Health, Madrid, Spain.
Abstract
BACKGROUND: The aim of this work was to construct a model for anxiety in PD and compare the relative contributions of PD-specific and -nonspecific general population risk factors for anxiety in this model. METHODS: Structural equation modeling of associations of risk factors with the anxiety outcome using a cross-sectional data set of 342 patients with PD were used. RESULTS: A model with acceptable to good fit was generated that explained 65% of the variance in anxiety scores. A previous history of depression and the severity of the depressive symptoms scored on the Hamilton Depression Rating Scale were the only nonspecific variables with a direct effect on anxiety. The presence of motor fluctuations and disease-related decline in activities of daily living were PD-specific markers of anxiety. Nonspecific risk factors had a greater influence in the model than PD-specific risk factors. Standardized regression coefficients suggested that the Hamilton Depression Rating Scale score was the most important contributor to the variation in anxiety. A post-hoc analysis showed that the effects of the following variables on anxiety levels were fully mediated by depression: sex; family history of depression; previous history of anxiety; cognitive status; difficulties in non-disease-specific activities of daily living; and severity of motor signs. CONCLUSION: In this cross-sectional study, we showed that nonspecific general population risk factors are more important markers for anxiety than PD-specific risk factors. Depression was the most prominent marker. PD-specific markers for anxiety appear to be more situational and related to off periods and disease-specific disturbances of activities of daily living.
BACKGROUND: The aim of this work was to construct a model for anxiety in PD and compare the relative contributions of PD-specific and -nonspecific general population risk factors for anxiety in this model. METHODS: Structural equation modeling of associations of risk factors with the anxiety outcome using a cross-sectional data set of 342 patients with PD were used. RESULTS: A model with acceptable to good fit was generated that explained 65% of the variance in anxiety scores. A previous history of depression and the severity of the depressive symptoms scored on the Hamilton Depression Rating Scale were the only nonspecific variables with a direct effect on anxiety. The presence of motor fluctuations and disease-related decline in activities of daily living were PD-specific markers of anxiety. Nonspecific risk factors had a greater influence in the model than PD-specific risk factors. Standardized regression coefficients suggested that the Hamilton Depression Rating Scale score was the most important contributor to the variation in anxiety. A post-hoc analysis showed that the effects of the following variables on anxiety levels were fully mediated by depression: sex; family history of depression; previous history of anxiety; cognitive status; difficulties in non-disease-specific activities of daily living; and severity of motor signs. CONCLUSION: In this cross-sectional study, we showed that nonspecific general population risk factors are more important markers for anxiety than PD-specific risk factors. Depression was the most prominent marker. PD-specific markers for anxiety appear to be more situational and related to off periods and disease-specific disturbances of activities of daily living.
Authors: Martinus P G Broen; A F G Leentjens; J T Hinkle; A J H Moonen; M L Kuijf; N M Fischer; K Perepezko; A Bakker; G M Pontone Journal: J Geriatr Psychiatry Neurol Date: 2018-03-11 Impact factor: 2.680
Authors: L M Chahine; R Feldman; A Althouse; B Torsney; L Alzyoud; S Mantri; B Edison; S Albert; M Daeschler; C Kopil; C Marras Journal: J Neurol Date: 2021-02-25 Impact factor: 4.849
Authors: Josiel Mileno Mack; Marissa Giovanna Schamne; Tuane Bazanella Sampaio; Renata Aparecida Nedel Pértile; Pedro Augusto Carlos Magno Fernandes; Regina P Markus; Rui Daniel Prediger Journal: Oxid Med Cell Longev Date: 2016-10-18 Impact factor: 6.543