Prevalence and Risk Factors of Depression and Anxiety in Essential Tremor Patients: A Cross-Sectional Study in Southwest China

Abstract

Background: Essential tremor (ET) is one of the most common movement disorders, and it has been associated with anxiety and depression, but risk factors for these mental symptoms are unclear. This study aimed to evaluate the prevalence and potential risk factors of depression and anxiety in ET patients in China.Methods: This cross-sectional study involved 245 Han Chinese patients with ET. Depression was assessed using the Hamilton Depression Rating Scale-24 Items, and anxiety was assessed using the Hamilton Anxiety Rating Scale. Clinico-demographic characteristics were compared between patients with or without depression or anxiety.Results: We revealed that 63.3% of patients had at least mild anxiety and 54.3% had at least mild depression. Severity of anxiety or depression was correlated with lower Mini-Mental State Exam score (P = 0.028 and P = 0.002, respectively), higher self-report functional disability score (P = 0.027 and P = 0.003, respectively), as well as the presence of tremor in the neck (both P < 0.001), face (P = 0.025 and P < 0.001, respectively), or voice (both P < 0.001). Binary logistic regression identified female sex, presence with cranial tremor, and greater functional disability score as risk factors of anxiety; the last two factors were also the determinants of depression. Neither anxiety nor depression correlated with physician-assessed severity of arm or leg tremor.Conclusion: Chinese ET patients show high prevalence of depression and anxiety. ET patients should be screened for these mental symptoms, especially women and those with cranial tremor and self-reported functional disability.

Phenotypic Features of Isolated Essential Tremor, Essential Tremor Plus, and Essential Tremor-Parkinson’s Disease in a Movement Disorders Clinic

“…Non-motor features, particularly depression and anxiety, have been increasingly reported in patients with isolated ET [ 3 37 38 39 40 41 42 43 ]. However, other studies have not found a significant association between depression and ET [ 44 ].…”

Non‐motor symptoms are associated with midline tremor in essential tremor

“…In our previous study, we explored the correlation between affective symptoms and MT, which revealed MT to be associated with anxiety and depression symptoms in ET 22 . Recently, Bologna et al 9 reported patients with head tremor to have a higher occurrence of psychiatric disorders, and Peng et al 23 showed that ET patients with head tremor had a higher incidence of memory and affective disorders than patients without head tremor.…”

Positive modulation of cerebellar α6GABAAreceptors for treating essential tremor: a proof-of-concept study in harmaline-treated mice

“…It is one of the most common movement disorders, especially in the elderlys (Louis and Ferreira, 2010;Sepúlveda Soto and Fasano, 2020), and a potential risk factor for other neuropsychiatric conditions, such as depression and anxiety (Huang et al, 2019;Louis, 2010). The socio-economic burden inflicted by ET is insurmountable, as it negatively affects the well-being and productivity of the patients and their caregivers (Monin et al, 2017).…”