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Defining Atypical Anxiety in Parkinson's Disease
Author(s) -
Forbes Elana J.,
Byrne Gerard J.,
O'Sullivan John D.,
Yang Jihyun,
Marsh Rodney,
Dissanayaka Nadeeka N.
Publication year - 2021
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.13193
Subject(s) - anxiety , anxiety disorder , generalized anxiety disorder , social anxiety , psychiatry , psychology , parkinson's disease , clinical psychology , hamilton anxiety rating scale , depression (economics) , neurology , medicine , disease , economics , macroeconomics
Background Anxiety is a major complication in Parkinson's disease (PD). Many PD patients experience clinically significant anxiety not meeting Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV) anxiety disorder criteria. This atypical anxiety (anxiety disorder not otherwise specified [NOS]) is often under‐recognized and its diagnosis is underdeveloped. Objectives This study aimed to identify the demographic, psychiatric, and clinical characteristics of anxiety disorder NOS in PD. Methods A cross‐sectional design studied a convenience sample of 184 PD patients without dementia recruited from neurology outpatient clinics. A semi‐structured interview using DSM‐IV criteria categorized PD patients into current anxiety disorder NOS (n = 28), DSM‐IV anxiety disorders (n = 42) or no anxiety (n = 86) groups. Logistic regression modeling identified characteristics associated with the anxiety disorder NOS group compared to DSM‐IV anxiety and no anxiety groups. Results The anxiety disorder NOS group was associated with motor complications of PD therapy, episodic, persistent and social anxiety symptoms, depression, non‐motor experiences of daily living, poor quality of life, and female sex compared to the no anxiety group. Compared to DSM‐IV anxiety, those with anxiety disorder NOS demonstrated greater global cognitive impairment, more severe motor complications of PD therapy, a greater severity and functional impact of dyskinesias, and greater complexity of motor fluctuations. Persistent, episodic, and social anxiety symptoms did not significantly differ between anxiety disorder NOS and DSM‐IV anxiety groups. Conclusions These findings suggest that PD‐specific symptoms characterize anxiety in a subgroup of PD patients who do not fulfill DSM‐IV criteria for anxiety disorders.