Self-report depressive symptoms are dissociated from tremor severity in essential tremor

Huey, Edward D.; Cosentino, Stephanie; Chapman, Silvia; Azar, Martina; Rohl, Brittany; Collins, Kathleen; Morgan, Sarah; Liu, Xinhua; Louis, Elan D.

doi:10.1016/j.parkreldis.2018.02.031

Cited by 18 publications

(17 citation statements)

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“…Based on a score of above 8 on the KDS-II, demoralization was found to have a prevalence of 13.3% in ET in our cohort. Demoralization was not associated with tremor severity, similar to that which is seen in studies of depression in ET, [15][16][17][18][19][20][21] where tremor severity did not positively correlate with depression. 13 Rather, as expected, demoralization was associated with related constructs including high levels of subjective incompetence and low levels of resilience.…”

Section: Discussionsupporting

confidence: 82%

“…First, in a cross-sectional study, severity of tremor in ET was not associated with severity of depressive symptoms. 15 Second, in a prospective study of normal, tremor-free individuals, baseline self-reported depression was associated with increased risk of developing ET during follow-up (adjusted relative risk = 1.78, p = 0.018), suggesting that in some instances the mood disorder could be a primary feature of the underlying disease, occurring prior to onset of tremor. 16 These data suggest that depressive symptoms may not be a mere consequence of tremor in ET, but rather a separable comorbid entity or a marker of a certain premorbid tendency.…”

Section: Introductionmentioning

confidence: 98%

“…16 These data suggest that depressive symptoms may not be a mere consequence of tremor in ET, but rather a separable comorbid entity or a marker of a certain premorbid tendency. [15][16][17][18][19][20][21] Demoralization, another manifestation of psychological distress, has been well-described in various chronic illnesses, and is characterized by feelings of helplessness, hopelessness, a sense of bewilderment, and an inability to cope in stressful situations. [22][23][24][25] Though demoralization can be associated with depression, they are distinct psychological phenomena with independent prognostic implications.…”

Section: Introductionmentioning

confidence: 99%

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Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity

et al. 2019

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Objective.Essential tremor (ET) is associated with psychological difficulties, including anxiety and depression. Demoralization (feelings of helplessness, hopelessness, inability to cope), another manifestation of psychological distress, has yet to be investigated in ET. Our objectives are to (1) estimate the prevalence of demoralization in ET, (2) assess its clinical correlates, and (3) determine whether demoralization correlates with tremor severity.Methods.We administered the Kissane Demoralization Scale (KDS-II) and several psychosocial evaluations (ie, scales assessing subjective incompetence, resilience, and depression [eg, Geriatric Depression Scale]) to 60 ET subjects. Tremor was assessed with a disability score and total tremor score. KDS-II >8 indicated demoralization.Results.Among 60 ET subjects (mean age = 70.2 ± 6.8 years), the prevalence of demoralization was 13.3%, 95% confidence interval = 6.9–24.2%. Although there was overlap between demoralization and depression (10% of the sample meeting criteria for both), 54% of depressed subjects were not demoralized, and 25% of demoralized subjects were not depressed. Demoralization correlated with psychological factors, but demoralized subjects did not have significantly higher total tremor scores, tremor disability scores, or years with tremor.Conclusions.Demoralization has a prevalence of 13.3% in ET, similar to that in other chronic or terminal illnesses (eg, cancer 13–18%, Parkinson’s disease 18.1%, coronary heart disease 20%). Demoralization was not a function of increased tremor severity, suggesting that it is a separable construct, which could dictate how a patient copes with his/her disease. These data further our understanding of the psychological and psychosocial correlates of ET.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity

et al. 2019

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“…Our findings confirmed the presence of apathy/depression symptoms in patients with ET. Previous studies have reported that the prevalence of depression among patients with ET ranges from 20% to 36% based on different affective disorder rating scales and evaluating methods 27,28 . Our results showed a similar prevalence with the ETh group seemingly having worse depression/apathy or anxiety symptoms.…”

Section: Discussionsupporting

confidence: 79%

Distinct non‐motor features of essential tremor with head tremor patients

Peng

et al. 2020

Acta Neurol Scand

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Background There have been few comprehensive scale studies on the non‐motor symptoms (NMS) of patients with essential tremor (ET) with head tremor (ETh) and those with ET without head tremor (ETol). We aimed to explore the motor symptoms and NMS of these two subgroups. Methods We enrolled 199 patients with ET (125, ETol; 74 ETh) and 132 healthy controls. We evaluated motor symptoms using the Fahn‐Tolosa‐Marin Tremor Rating Scale (TRS) and NMS using the Non‐Motor Symptom Scale (NMSS). We compared NMSS scores and the prevalence of each NMS between the patient subgroups. Finally, we conducted a logistic regression analysis of the correlation between head tremor and NMS severity, as well as other determinants. Results There were no significant between‐subgroup differences in demographic characteristics. Further, they presented similar tremor clinical manifestation; however, the ETh subgroup showed a higher prevalence of rest tremor, feeling of sadness, forgetting things or events, and swallowing difficulty, as well as TRS scores, compared with the ETol subgroup. Both patient subgroups showed high scores and prevalence (>50%) in difficulty falling asleep. Logistic regression analysis indicated age as a tremor severity determinant; further, head tremor and tremor severity were NMS determinants. Conclusion Both patient subgroups presented various NMS including sleep disturbances, cognitive deficits, and affective disorders. The ETh subgroup showed a high prevalence of certain NMS aspects including memory and affective disorder; further, they had aggravated NMS. ET with both upper limb tremor and head tremor may be regarded as a more severe clinical subtype.

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“…7,24 These results were also consistent with a large door-to-door study using Hamilton Depression Rating Scale (HDRS). 25 In contrast, previous studies used the Geriatric Depression Scale (GDS) that reported significant depression with ET, but without correlation to tremor severity, 19,26 while a recent study detected non-significant difference in BDI. 9 These variable findings could be explained by using different depression scales and variable number of recruited ET patients, and maintain the debate of the nature of depression as a reaction to the tremor or inherent part of the illness.…”

Section: Discussionmentioning

confidence: 92%

Clinical Profile of Non-Motor Symptoms in Patients with Essential Tremor: Impact on Quality of Life and Age-Related Differences

Shalash

Mohamed

Mansour

et al. 2019

Tremor and Other Hyperkinetic Movements

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Self-report depressive symptoms are dissociated from tremor severity in essential tremor

Cited by 18 publications

References 37 publications

Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity

Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity

Distinct non‐motor features of essential tremor with head tremor patients

Clinical Profile of Non-Motor Symptoms in Patients with Essential Tremor: Impact on Quality of Life and Age-Related Differences

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