Abstract
Anxiety disorders in patients with Parkinson’s disease (PD) are often missed due to an overlap with other non-motor symptoms. The relationships between anxiety and other non-motor symptoms in PD still remain unclear. We used the Hamilton anxiety rating scale and the Non-motor Symptoms Questionnaire to measure anxiety and the complex range of non-motor symptoms in 99 PD patients. The relationships between anxiety and other PD-related non-motor symptoms were examined through regression analyses. 25 % of PD patients were diagnosed with clinically relevant anxiety. Non-motor symptoms were more prominent in patients with anxiety. Depression, urinary disorders, and sleep disruption were the factors most likely to influence anxiety in PD. Our findings have revealed a strong interplay between anxiety and other non-motor symptoms of PD and have highlighted the need for a holistic approach towards the clinical treatment of this disabling condition.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Soh SE, Morris ME, McGinley JL (2011) Determinants of health-related quality of life in Parkinson’s disease: a systematic review. Parkinsonism Relat Disord 17:1–9
Chen JJ, Marsh L (2014) Anxiety in Parkinson’s disease identification and management. Ther Adv Neurol Disord 7:52–59
Dissanayaka NN, White E, O’Sullivan JD et al (2014) The clinical spectrum of anxiety in Parkinson’s disease. Mov Disord 29:967–975
Pontone GM, Williams JR, Anderson KE et al (2009) Prevalence of anxiety disorders and anxiety subtypes in patients with Parkinson’s disease. Mov Disord 24:1333–1338
Shulman LM, Taback RL, Rabinstein AA et al (2002) Non-recognition of depression and other non-motor symptoms in Parkinson’s disease. Parkinsonism Relat Disord 8:193–197
Vazquez A, Jimenez-Jimenez FJ, Garcia-Ruiz P et al (1993) “Panic attacks” in Parkinson’s disease. A long-term complication of levodopa therapy. Acta Neurol Scand 87:14–18
Lauterbach EC, Freeman A, Vogel RL (2003) Correlates of generalized anxiety and panic attacks in dystonia and Parkinson disease. Cogn Behav Neurol 16:225–233
Rutten S, Ghielen I, Vriend C et al (2015) Anxiety in Parkinson’s disease: symptom dimensions and overlap with depression and autonomic failure. Parkinsonism Relat Disord 21:189–193
Hughes AJ, Daniel SE, Kilford L et al (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184
Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442
Fahn S (2005) Does levodopa slow or hasten the rate of progression of Parkinson’s disease? J Neurol 252 (suppl 4):IV37–IV42
Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Wenzelburger R, Zhang B, Pohle S (2002) Force overflow and levodopa-induced dyskinesias in Parkinson’s disease. Brain 125:871–879
Leentjens AF, Dujardin K, Marsh L et al (2010) Anxiety rating scales in Parkinson’s disease: a validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale. Mov Disord 26:407–415
Chaudhuri KR, Martinez-Martin P, Schapira AH et al (2006) International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson’s disease: the NMSQuest study. Mov Disord 21:916–923
Jack M, Gorman MD (1996) Comorbid depression and anxiety spectrum disorders. Depress Anxiety 4:160–168
Yamanishi T, Tachibana H, Oguru M et al (2013) Anxiety and Depression in Patients with Parkinson’s Disease. Intern Med 52:539–545
Kano O, Ikeda K, Cridebring D et al (2011) Neurobiology of depression and anxiety in Parkinson’s disease. Parkinson’s Disease 2011:143547–143551
Leentjens AF, Dujardin K, Marsh L et al (2011) Symptomatology and markers of anxiety disorders in Parkinson’s disease: a cross-sectional study. Mov Disord 26:484–492
De Luka SR, Svetel M, Pekmezovic T et al (2014) When do the symptoms of autonomic nervous system malfunction appear in patients with Parkinson’s disease? Vojnosanit Pregl 71:346–351
Burnum JF, Hickam JB, Mc IH (1954) The effect of hypocapnia on arterial blood pressure. Circulation 9:89–95
Berrios GE, Campbell C, Politynska BE (1995) Autonomic failure, depression and anxiety in Parkinson’s disease. Br J Psychiatry 166:789–792
Borek LL, Kohn R, Friedman JH (2006) Mood and sleep in Parkinson’s disease. J Clin Psychiatry 67:958–963
Leentjens AF, Dujardin K, Marsh L et al (2008) Anxiety rating scales in Parkinson’s disease:critique and recommendations. Mov Disord 23:2015–2025
Acknowledgments
This work was supported by the Natural science foundation of Jiangsu Province (No. BK20141494), the Jiangsu Provincial Personnel Department “the Great of Six Talented Man Peak” Project (No. 2014-WSN-013), the University Natural Science Research Project in Jiangsu Province (No. 13KJB32009), the Opening Project of Jiangsu Key Laboratory of Neurodegeneration (No. SJ11KF01), and Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The authors declare that they have no conflict of interest.
Additional information
S.-M. Jiang, Y.-S. Yuan and Q. Tong contributed equally to this work.
Rights and permissions
About this article
Cite this article
Jiang, SM., Yuan, YS., Tong, Q. et al. The association between clinically relevant anxiety and other non-motor symptoms in Parkinson’s disease. Neurol Sci 36, 2105–2109 (2015). https://doi.org/10.1007/s10072-015-2320-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-015-2320-0