Journal
MOVEMENT DISORDERS
Volume 24, Issue 9, Pages 1333-1338Publisher
WILEY
DOI: 10.1002/mds.22611
Keywords
Parkinson's disease; nonmotor symptoms; anxiety; psychiatric disorders
Categories
Funding
- NIH [R01MH069666]
- Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins [NIH-P50-NS-58377]
- Age-Related Cognitive Disorders Training Grant [NIH5T32-AG-027668-02]
- Parkinson Study Group Mentored Clinical Research Award
- Donna Jeanne Gault Baumann Fund
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Anxiety disorders are common in Parkinson's disease (PD), but are not well characterized. This study determined the prevalence and clinical correlates of all DSM-IV-TR anxiety disorder diagnoses in a sample of 127 subjects with idiopathic PD who underwent comprehensive assessments administered by a psychiatrist and neurologist. A panel of six psychiatrists with expertise in geriatric psychiatry and/or movement disorders established by consensus all psychiatric diagnoses. Current and lifetime prevalence of at least one anxiety disorder diagnosis was 43% (n = 55) and 49% (n = 63), respectively. Anxiety disorder not otherwise specified, a DSM diagnosis used for anxiety disturbances not meeting criteria for defined subtypes, was the most common diagnosis (30% lifetime prevalence, n = 38). Compared with nonanxious subjects, panic disorder (n = 13) was associated with earlier age of PD onset [50.3 (12.2) vs. 61.0 (13.7) years, P < 0.01], higher rates of motor fluctuations [77% (10/13) vs. 39% (25/64), P = 0.01] and morning dystonia [38% (5/ 13) vs. 13% (8/62), P < 0.03]. This high prevalence of anxiety disorders, including disturbances often not meeting conventional diagnostic criteria, suggests that anxiety in PD is likely underdiagnosed and undertreated and refined characterization of anxiety disorders in PD is needed. In addition, certain anxiety subtypes may be clinically useful markers associated with disease impact in PD. (C) 2009 Movement Disorder Society
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