Non-recognition of depression and other non-motor symptoms in Parkinson's disease

Shulman, Lisa M.; Taback, Robin Leifert; Rabinstein, A.A.; Weiner, William J.

doi:10.1016/s1353-8020(01)00015-3

Cited by 597 publications

(416 citation statements)

References 21 publications

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“…The first articles highlighting the importance of fatigue in PD were published only in 1993 [5,8]; however, fatigue has received more recognition only in the last decade. Despite its high prevalence and importance, fatigue in PD remains an under-recognized problem in routine clinical practice [9].…”

Section: Introductionmentioning

confidence: 99%

Clinical determinants of primary and secondary fatigue in patients with Parkinson’s disease

et al. 2013

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Clinical and psychosocial factors associated separately with primary and secondary fatigue in Parkinson's disease (PD) patients have not been thoroughly studied before. The aim of our study was to assess factors associated with different fatigue domains in groups with primary and secondary fatigue in PD separately. We divided 165 nondemented PD patients according to the absence/presence of depression, anxiety and excessive somnolence into groups with primary fatigue (N = 63) and with secondary fatigue (N = 102). Fatigue domains examined using the multidimensional fatigue inventory were associated through multiple linear regression analyses for each group separately with sociodemographic data, disease duration, functional status as assessed by the Unified Parkinson's Disease Rating Scale, treatment, depression, anxiety, excessive somnolence and sleep quality. Out of the assessed non-motor symptoms, fatigue was the most frequent (77.6 %). The prevalence of fatigue in the secondary fatigue group was significantly higher than in the primary fatigue group. Both fatigue groups differed significantly in factors associated with different fatigue domains. Functional status or other disease-related factors were not associated with primary fatigue. In the secondary fatigue group, we found associations between some fatigue domains and functional status, older age, male gender and higher anxiety scores. To our knowledge, this is the first study to separately describe clinical determinants and psychosocial factors associated with different fatigue domains in primary and secondary fatigue in PD, underlining the importance of distinguishing primary and secondary fatigue in future PD studies and clinical practice.

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Section: Introductionmentioning

confidence: 99%

Clinical determinants of primary and secondary fatigue in patients with Parkinson’s disease

et al. 2013

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“…This can pose a challenge to measurement. In Parkinson's disease (PD), fatigue has been reported in 40-65% of patients and although many consider it to be one of their most disabling symptoms, it often remains undetected in clinical practice (4)(5)(6)(7)(8). Its cause remains unclear.…”

Section: Introductionmentioning

confidence: 99%

“…Studies have tended to use fatigue scales from generic health status questionnaires or approaches not validated in PD (4)(5)(6)(7)(8)(10)(11)(12). Although generic health status questionnaires have been validated broadly, their subscales are brief and often lack sufficient detail for accurately measuring individuals.…”

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confidence: 99%

Measuring Fatigue in Parkinson's Disease: A Psychometric Study of Two Brief Generic Fatigue Questionnaires

Hagell

Höglund

Reimer

et al. 2006

Journal of Pain and Symptom Management

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This study evaluated and compared the measurement properties of the 13-item FACITFatigue Scale (FACIT-F) and the 9-item Fatigue Severity Scale (FSS) in 118 consecutive Parkinson's disease (PD) patients, using traditional and Rasch measurement methodologies.Both questionnaires exhibited excellent data quality and reliability (coefficient alpha ≥0.9), acceptable rating scale functionality, and discriminated between fatigued and non-fatigued patients. Factor and Rasch analyses provided general support for unidimensionality of both the FACIT-F and FSS, although they do not appear to measure identical aspects of fatigue.No signs of differential item functioning (DIF) were found for the FACIT-F whereas potential age DIF was detected for 2 FSS items. These results support the measurement validity of both questionnaires in PD, although the FACIT-F displayed better measurement precision and modest psychometric advantages over the FSS. Availability of psychometrically sound fatigue measures that are applicable across disorders provides a sound basis for advancing the understanding of this common and distressing complaint. Fatigue can be defined as an overwhelming sense of tiredness, lack of energy, and feeling of exhaustion (1) and is a common complaint in a range of medical conditions, including many neurological disorders (1-3). In a clinical context, fatigue is considered to be a multidimensional concept with physical, emotional, cognitive, and social aspects. This can pose a challenge to measurement. In Parkinson's disease (PD), fatigue has been reported in 40-65% of patients and although many consider it to be one of their most disabling symptoms, it often remains undetected in clinical practice (4)(5)(6)(7)(8). Its cause remains unclear. For example, while some reports suggest an association between fatigue and the underlying parkinsonism (5, 9), others do not (10, 11).One reason for such mixed results may relate to how fatigue has been assessed. Studies have tended to use fatigue scales from generic health status questionnaires or approaches not validated in [10][11][12]. Although generic health status questionnaires have been validated broadly, their subscales are brief and often lack sufficient detail for accurately measuring individuals. For example, the Energy subscale of the Nottingham Health Profile (NHP-EN) (13) has been found to be only a coarse measure of fatigue (14). Other employed instruments have been validated in other patient groups but remain untested in terms of their measurement properties in PD. This is a limitation because traditional psychometric properties are sample dependent. Thus their performance in specific applications is important to consider in the context of accumulated experience with an instrument (15). There is thus a need for fatigue measures with documented reliability and validity in specific patient populations, such as PD, that also allow for comparisons with other patient groups and healthy control populations (3).We therefore sought to identify and validate an availa...

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“…Most patients with PD include fatigue as one of their three most prominent symptoms, and claim that it substantially impacts quality of life [1][2][3][4], yet neurologists tend to underdiagnose fatigue as a presenting symptom of PD [5]. Clinically, fatigue can be described as an "overwhelming sense of tiredness, lack of energy, or feeling of exhaustion" [6].…”

Section: Introductionmentioning

confidence: 99%

Perceptions of effort during handgrip and tongue elevation in Parkinson's disease

Solomon

Robin

2005

Parkinsonism & Related Disorders

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Background-Fatigue and the accompanying perception of effort are often heightened in Parkinson's disease.Objectives-To compare performance on three sense-of-effort tasks between patients with PD and matched neurologically normal control subjects.Methods-Sixteen PD subjects and 16 normal subjects performed three tasks to assess sense of effort: self-ratings of effort using direct-magnitude estimation, generating pressures at various levels of effort, and sustaining a submaximal level of effort. The latter two tasks were done with handgrip and tongue elevation.Results-Two of the three tasks successfully differentiated the groups. Subjects with PD provided significantly higher ratings of effort for general daily activities and for speech. During the constant-effort task, pressure curves decayed more rapidly for the PD subjects.Conclusions-Performance by PD subjects on the constant-effort task resembled that by normal adults who were pre-fatigued in previous experiments. Results support greater than normal senseof-effort related to fatigue in PD, and provide preliminary validation of a performance-based physiologic task to assess abnormal sense of effort in this population.

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Non-recognition of depression and other non-motor symptoms in Parkinson's disease

Cited by 597 publications

References 21 publications

Clinical determinants of primary and secondary fatigue in patients with Parkinson’s disease

Clinical determinants of primary and secondary fatigue in patients with Parkinson’s disease

Measuring Fatigue in Parkinson's Disease: A Psychometric Study of Two Brief Generic Fatigue Questionnaires

Perceptions of effort during handgrip and tongue elevation in Parkinson's disease

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