Modeling anxiety in Parkinson's disease. Issue 3 (21st December 2015)

• Record Type: Journal Article
• Authors: Broen, Martijn P.G.; Köhler, Sebastian; Moonen, Anja J.H.; Kuijf, Mark L.; Dujardin, Kathy; Marsh, Laura; Richard, Irene H.; Starkstein, Sergio E.; Martinez‐Martin, Pablo; Leentjens, Albert F.G.
• Is Part Of: Movement disorders. Volume 31:Issue 3(2016)
• Page Start: 310
• Page End: 316
• Publication Date: 2015-12-21
• Subjects: Parkinson's disease -- anxiety -- depression -- model -- risk factor; Movement disorders -- Periodicals; 610
• DOI: 10.1002/mds.26461
• Languages: English
• ISSNs: 0885-3185

Abstract

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. © 2015 International Parkinson and Movement Disorder Society