Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis

Landau, Sabine; Harris, Vicki; Burn, David J.; Hindle, John V.; Hurt, Catherine S.; Samuel, Mike; Wilson, Ken; Brown, Richard G.

doi:10.1017/s0033291715002196

Cited by 59 publications

(48 citation statements)

References 55 publications

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“…Clinical studies have demonstrated the significance of adverse impact of even subclinical depression on quality of life. In the present study, the frequency of depression was found to be 27.6% [20][21][22] . Fluctuating course of depressive symptoms as in motor symptoms, especially more severely in off-periods, is of great significance for the optimization of treatment.…”

Section: Discussionsupporting

confidence: 51%

The Assessment of Non-Motor Symptoms in Idiopathic Parkinson’s Disease

Genç¹,

Erdal²,

Gömceli³

et al. 2017

MMJ

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Section: Discussionsupporting

confidence: 51%

The Assessment of Non-Motor Symptoms in Idiopathic Parkinson’s Disease

Genç¹,

Erdal²,

Gömceli³

et al. 2017

MMJ

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“…Moreover, as has been suggested to optimize psychotherapy response for older adults, the current CBT protocol also was tailored to address the specific needs of the dPD population. For example, depressed PWP endorse very high levels of anhedonia, anxiety somatic symptoms, fatigue, sleep disturbance, rumination, and behavioral avoidance . They are also more psychiatrically complicated, with higher rates of comorbid anxiety and depression (vs matched controls), and depression chronicity .…”

Section: Discussionmentioning

confidence: 99%

“…As somatic dPD symptoms may worsen more with PD progression compared with other depressive symptoms, 37 dPD patients with significant somatic symptomatology may especially benefit from initiating combined treatment earlier in the PD process, to take advantage of the potential synergis- Moreover, as has been suggested to optimize psychotherapy response for older adults, 35 the current CBT protocol also was tailored to address the specific needs of the dPD population. For example, depressed PWP endorse very high levels of anhedonia, 38 anxiety 39,40 somatic symptoms, 41 fatigue, 42 sleep disturbance, 43 rumination, and behavioral avoidance. 44 They are also more psychiatrically complicated, with higher rates of comorbid anxiety and depression (vs matched controls), 39,40 and depression chronicity.…”

Section: Discussionmentioning

confidence: 99%

“…For example, depressed PWP endorse very high levels of anhedonia, 38 anxiety 39,40 somatic symptoms, 41 fatigue, 42 sleep disturbance, 43 rumination, and behavioral avoidance. 44 They are also more psychiatrically complicated, with higher rates of comorbid anxiety and depression (vs matched controls), 39,40 and depression chronicity. 9,11,45 comorbidity rates, based on SCID, as high as 75% or 92% in PD samples.…”

Section: Discussionmentioning

confidence: 99%

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Cognitive behavioral therapy improves diverse profiles of depressive symptoms in Parkinson's disease

Dobkin

Mann

Interian

et al. 2019

Int J Geriat Psychiatry

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Objective Depression is among the most common and debilitating nonmotor complaints in Parkinson's disease (PD), yet there is a paucity of controlled research to guide treatment. Little research has focused on the extent to which specific depressive symptom profiles may dictate unique clinical recommendations to ultimately improve treatment outcomes. The current study examined the impact of cognitive behavioral therapy (CBT) on different types of depressive symptoms in PD. It was hypothesized that the cognitive (eg, guilt, rumination, and negative attitudes towards self) and behavioral (eg, avoidance and procrastination) symptoms targeted most intensively by the treatment protocol would show the most robust response. The extent to which stabilized antidepressant use moderated specific symptom change was examined on an exploratory basis. Method Eighty depressed people with PD participated in a randomized controlled trial of CBT plus clinical management, versus clinical management only. Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI) subscale scores, reflecting depressive symptom heterogeneity in PD, were the focus of this investigation. Results CBT response was associated with significant improvements in mood, sleep, anxiety, and somatic symptoms (HAMD), and negative attitudes toward self, performance impairment, and somatic symptoms (BDI). As hypothesized, the largest effect sizes were observed for cognitive and behavioral (vs somatic) symptoms of depression. Stabilized antidepressant use moderated the effect of CBT on somatic complaints (HAMD and BDI). Conclusions CBT may improve a diverse array of depressive symptoms in PD. Cognitive and behavioral (vs somatic) symptoms showed the greatest change. Combining CBT with antidepressants may help optimize the management of somatic complaints in depression in PD (dPD).

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“…These non-motor complications are better predictors of disability, distress and rates to institutionalisation than the motor symptoms 3. Of the non-motor complications, mixed depression and anxiety is the most common psychiatric comorbidity, affecting ∼50% of PD patients, significantly more common that rates in the general population 4. Depression and anxiety are the strongest predictors of poorer quality of life,5 even in the advanced stages of the illness where the motor features have progressed fully 6.…”

Section: Introductionmentioning

confidence: 99%

Cognitive–behavioural therapy for non-motor symptoms of Parkinson's disease: a clinical review

Koychev

Okai

2017

Evid Based Mental Health

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Neuropsychiatric symptoms are common in Parkinson's disease (PD) and have a disproportionate impact on quality of life and carer burden. Pharmacological treatment is the main approach in dealing with these symptoms, but it is limited by variable efficacy and risk of drug interactions. Non-pharmacological approaches using the cognitive-behavioural therapy (CBT) model are viable alternatives and in this review paper we summarise the evidence of CBT for three of the most common psychiatric manifestations of PD: depression and anxiety, impulse-control disorders and insomnia. Most studies modified the usual CBT format to include modules accounting for problems specific to PD: activity scheduling around motoric function, motor symptoms as triggers of anxiety, fear of falling and preparation for disease progression as well as accommodation of materials for suspected executive dysfunction. We found a growing evidence base that CBT (modified to account for PD-specific problems) is effective in the treatment of PD psychiatric symptoms. Where controlled study design was used, moderate effect sizes are reported for the efficacy of CBT for depression, including with distance administration of CBT. The effects were sustained during follow-up which was between 1 and 6 months. In addition, there are some initial data on the effects of CBT on impulse-control disorders and insomnia. The studies were limited by their small and potentially unrepresentative samples and the quality of sample reporting (eg, concomitant antidepressant and dopaminergic therapy use). Additional welldesigned and adequately powered studies are required to determine the utility of CBT in PD. INTRODUCTIONParkinson's disease (PD) is classically defined by a triad of motor symptoms (tremor, rigidity and bradykinesia). It is, however, increasingly conceptualised as a neuropsychiatric disorder 1 in view of the high prevalence of psychiatric features, including depression, impulse control disorders (ICD) and sleep difficulties.2 These non-motor complications are better predictors of disability, distress and rates to institutionalisation than the motor symptoms.3 Of the non-motor complications, mixed depression and anxiety is the most common psychiatric comorbidity, affecting ∼50% of PD patients, significantly more common that rates in the general population.4 Depression and anxiety are the strongest predictors of poorer quality of life, 5 even in the advanced stages of the illness where the motor features have progressed fully.6 ICD are characterised by repetitive, reward-based behaviours, linked to the dopaminergic medication used to treat the motor symptoms. They affect ∼14% of all PD patients 7 and are associated with psychiatric comorbidity and high carer burden.8 Sleep disturbance is another neuropsychiatric symptom that affects up to 60% of all PD patients.9 It is associated with somnolence 10 and impairment in attention and executive function.11 On the basis of their impact on quality of life and outcome, the recognition and treatment of neuropsych...

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Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis

Cited by 59 publications

References 55 publications

The Assessment of Non-Motor Symptoms in Idiopathic Parkinson’s Disease

The Assessment of Non-Motor Symptoms in Idiopathic Parkinson’s Disease

Cognitive behavioral therapy improves diverse profiles of depressive symptoms in Parkinson's disease

Cognitive–behavioural therapy for non-motor symptoms of Parkinson's disease: a clinical review

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