TY - JOUR
T1 - Clinical Markers of Anxiety Subtypes in Parkinson Disease
AU - Broen, Martinus P.G.
AU - Leentjens, A. F.G.
AU - Hinkle, J. T.
AU - Moonen, A. J.H.
AU - Kuijf, M. L.
AU - Fischer, N. M.
AU - Perepezko, K.
AU - Bakker, A.
AU - Pontone, G. M.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Pontone is supported by NIH K23 AG044441. A. F. G. Leentjens receives payment from Elsevier Inc as Editor-in-Chief of the Journal of Psychosomatic Research. He has received research grants from the Michael J Fox Foundation and the Stichting Internationaal Parkinson Fonds, as well as royalties from Reed-Elsevier, de Tijdstroom, and Van Gorcum publishers. J. T. Hinkle receives tuition and stipend support through the Medical Scientist Training Program at the Johns Hopkins School of Medicine (NIH/NIGMS 5 T32 GM007309). A. Bakker has received research grants from the National Institutes of Health and is an inventor on Johns Hopkins University intellectual property with patents pending and licensed to AgeneBio, Inc. G. M. Pontone has received research grants from the Michael J Fox Foundation and the National Institutes of Health.
Publisher Copyright:
© 2018, © The Author(s) 2018.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Objective: The aim of this work was to investigate marker profiles for proposed anxiety subtypes in Parkinson disease (PD). Methods: We used the persistent anxiety, episodic anxiety, and avoidance behavior subscales of the Parkinson Anxiety Scale as dependent variables in multivariable linear regression analyses using a cross-sectional data set of 311 patients with PD. Independent variables consisted of a range of demographic, psychiatric, and disease-specific markers. Results: In the most parsimonious model of persistent anxiety, higher Hamilton Depression Rating Scale scores, a history of anxiety, fewer years of education, lower Mini-Mental State Examination scores, lower Lawton Instrumental Activities of Daily Living scores, female sex, and complications of therapy (higher Unified Parkinson Disease Rating Scale part IV scores) were all associated with more severe persistent anxiety. Markers associated with more severe episodic anxiety included PD-specific disturbances of activities of daily living, complications of therapy, higher Hamilton Depression Rating Scale scores, female sex, and a history of anxiety. Finally, higher Hamilton Depression Rating Scale scores, a history of anxiety, complications of therapy, and longer disease duration were associated with avoidance behavior. After excluding clinically depressed patients with PD, disease severity and longer disease duration were significantly associated with episodic anxiety, but not with persistent anxiety. Conclusion: Persistent anxiety is mainly influenced by nonspecific markers, while episodic anxiety seems to be more PD-specific compared to persistent anxiety and may be more situational or contextual. These results provide support for possible distinct underlying constructs for anxiety subtypes in PD.
AB - Objective: The aim of this work was to investigate marker profiles for proposed anxiety subtypes in Parkinson disease (PD). Methods: We used the persistent anxiety, episodic anxiety, and avoidance behavior subscales of the Parkinson Anxiety Scale as dependent variables in multivariable linear regression analyses using a cross-sectional data set of 311 patients with PD. Independent variables consisted of a range of demographic, psychiatric, and disease-specific markers. Results: In the most parsimonious model of persistent anxiety, higher Hamilton Depression Rating Scale scores, a history of anxiety, fewer years of education, lower Mini-Mental State Examination scores, lower Lawton Instrumental Activities of Daily Living scores, female sex, and complications of therapy (higher Unified Parkinson Disease Rating Scale part IV scores) were all associated with more severe persistent anxiety. Markers associated with more severe episodic anxiety included PD-specific disturbances of activities of daily living, complications of therapy, higher Hamilton Depression Rating Scale scores, female sex, and a history of anxiety. Finally, higher Hamilton Depression Rating Scale scores, a history of anxiety, complications of therapy, and longer disease duration were associated with avoidance behavior. After excluding clinically depressed patients with PD, disease severity and longer disease duration were significantly associated with episodic anxiety, but not with persistent anxiety. Conclusion: Persistent anxiety is mainly influenced by nonspecific markers, while episodic anxiety seems to be more PD-specific compared to persistent anxiety and may be more situational or contextual. These results provide support for possible distinct underlying constructs for anxiety subtypes in PD.
KW - Parkinson disease
KW - anxiety
KW - depression
KW - risk factor
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U2 - 10.1177/0891988718757369
DO - 10.1177/0891988718757369
M3 - Article
C2 - 29528763
AN - SCOPUS:85043513047
SN - 0891-9887
VL - 31
SP - 55
EP - 62
JO - Journal of Geriatric Psychiatry and Neurology
JF - Journal of Geriatric Psychiatry and Neurology
IS - 2
ER -