Nadeeka N W Dissanayaka1,2,3, Elizabeth White1,4, John D O'Sullivan2,4, Rodney Marsh1,4,5, Peter A Silburn1,2,4, David A Copland1,6, George D Mellick1,2,7, Gerard J Byrne1,3,4,5. 1. UQ Center for Clinical Research Royal Brisbane & Women's Hospital University of Queensland Herston Brisbane Queensland Australia. 2. Neurology Research Center Royal Brisbane & Women's Hospital Herston Brisbane Queensland Australia. 3. School of Psychology The University of Queensland Brisbane Queensland Australia. 4. School of Medicine Royal Brisbane & Women's Hospital University of Queensland Herston Brisbane Queensland Australia. 5. Mental Health Service Royal Brisbane & Women's Hospital Herston Brisbane Queensland Australia. 6. School of Health & Rehabilitation Sciences University of Queensland St Lucia Brisbane Queensland Australia. 7. Eskitis Institute for Drug Discovery Griffith University Nathan Brisbane Queensland Australia.
Abstract
Background: Anxiety disorders are common in Parkinson's disease (PD) and are undertreated. The current study investigates demographic and PD-specific factors associated with Diagnostic and Statistical Manual (DSM-IV) anxiety disorders and subsyndromal anxiety in PD. It also examines the use of pharmacological and nonpharmacological treatments for anxiety in PD. Methods: Ninety nondemented PD patients completed a semistructured interview. Logistic regression models were constructed examining associations between several demographic, disease-specific, and treatment factors, as well as both current syndromal, DSM-IV anxiety disorders, and subsyndromal anxiety. Results: Associations were found between current DSM-IV anxiety disorder, as well as female gender, younger age, more severe stages of PD, and poor activities of daily living. Subsyndromal anxiety was related to a younger onset age of PD. Relationships were also found between both anxiety groups and more complications of PD therapy, as well as higher depression scores. There were no associations between anxiety and levodopa equivalent daily dosage, motor disability, and cognition. In our sample, 57% of patients with current DSM-IV anxiety disorders or subsyndromal anxiety were not currently treated with pharmacotherapy. Of those who currently received such treatment, 83% still experienced current anxiety disorders. Results suggest that anxiety is poorly recognized and treated in PD. Conclusions: Clinical trials investigating the efficacy of pharmacotherapy, tailored psychotherapy, and combination therapy primarily focusing on anxiety are much needed, with the aim of establishing novel targeted treatment protocols for the management of subtypes of anxiety disorders in PD.
Background: Anxiety disorders are common in Parkinson's disease (PD) and are undertreated. The current study investigates demographic and PD-specific factors associated with Diagnostic and Statistical Manual (DSM-IV) anxiety disorders and subsyndromal anxiety in PD. It also examines the use of pharmacological and nonpharmacological treatments for anxiety in PD. Methods: Ninety nondemented PDpatients completed a semistructured interview. Logistic regression models were constructed examining associations between several demographic, disease-specific, and treatment factors, as well as both current syndromal, DSM-IV anxiety disorders, and subsyndromal anxiety. Results: Associations were found between current DSM-IV anxiety disorder, as well as female gender, younger age, more severe stages of PD, and poor activities of daily living. Subsyndromal anxiety was related to a younger onset age of PD. Relationships were also found between both anxiety groups and more complications of PD therapy, as well as higher depression scores. There were no associations between anxiety and levodopa equivalent daily dosage, motor disability, and cognition. In our sample, 57% of patients with current DSM-IV anxiety disorders or subsyndromal anxiety were not currently treated with pharmacotherapy. Of those who currently received such treatment, 83% still experienced current anxiety disorders. Results suggest that anxiety is poorly recognized and treated in PD. Conclusions: Clinical trials investigating the efficacy of pharmacotherapy, tailored psychotherapy, and combination therapy primarily focusing on anxiety are much needed, with the aim of establishing novel targeted treatment protocols for the management of subtypes of anxiety disorders in PD.
Entities:
Keywords:
Parkinson's disease; anxiety; characteristics; quality of life; treatment
Authors: Nadeeka N W Dissanayaka; Anna Sellbach; Peter A Silburn; John D O'Sullivan; Rodney Marsh; George D Mellick Journal: J Affect Disord Date: 2011-02-26 Impact factor: 4.839
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