Anxiety Disorders in Parkinson's Disease: Prevalence and Risk Factors
Anxiety Disorders in Parkinson's Disease: Prevalence and Risk Factors
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DOI：
10.1002/mds.22833
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发表时间：
2010-05-15
影响因子：
8.6
通讯作者：
Mellick, George D.
中科院分区：
文献类型：
--
作者：
Dissanayaka, Nadeeka N. W.;Sellbach, Anna;Mellick, George D.
焦虑症在帕金森病（PD）患者中很常见，但研究很少。我们检查了焦虑障碍在PD中的患病率，调查了焦虑与PD的表现和进展之间的关系，并首次研究了PD中焦虑的假定危险因素的贡献。使用DSM-IV标准对从神经科门诊诊所招募的79名PD患者的病例系列进行了焦虑症检查。采用统一帕金森病评定量表和PD的Hoehn和Yahr分期来了解焦虑障碍与PD的临床表现和严重程度的关系。一项经验证的调查评估了PD患者焦虑的假定危险因素。25%的PD患者被诊断为焦虑。惊恐障碍、广泛性焦虑障碍和社交恐怖是常见的焦虑障碍。共病抑郁与焦虑（14%）。PD的严重程度而非持续时间与焦虑呈正相关。有姿势不稳定和步态功能障碍症状聚集的PD患者比震颤显性患者更容易经历焦虑。虽然左旋多巴剂量与焦虑无关，但运动障碍或开/关波动的经历增加了风险。PD的偏侧化与焦虑无关。焦虑障碍随着年龄的增长而减少，年轻发病的PD患者比晚发受试者更容易经历焦虑。焦虑增加了PD的复杂性，降低了患者的生活质量。未来的研究可以针对PD中焦虑的反应性和器质性。(C)2010年运动障碍协会
Anxiety disorders are common in Parkinson's disease (PD) patients, yet are poorly studied. We examined the prevalence of anxiety disorders in PD, investigated the association between anxiety, and presentation and progression of PD, and studied for the first time the contribution of putative risk factors for anxiety in PD. A case-series of 79 PD patients recruited from neurology out-patient clinics was examined for anxiety disorders using the DSM-IV criteria. The Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr Staging of PD were employed to understand the relationship between anxiety disorders, and the clinical presentation and severity of PD. A validated survey assessed putative risk factors for anxiety in PD. Twenty-five percent of PD patients were diagnosed with anxiety. Panic disorder, generalised anxiety disorder and social phobia were prevalent anxiety disorders. Comorbid depression with anxiety was observed (14%). The severity but not the duration of PD was positively related to anxiety. PD patients with postural instability and gait dysfunction symptom clustering were more likely to experience anxiety than tremor-dominant patients. While levodopa dosage had no relationship to anxiety, experience of dyskinesias or on/off fluctuations increased the risk. Lateralisation of PD had no association with anxiety. Anxiety disorders decreased with age and young onset PD patients were more likely to experience anxiety than the late onset subjects. Anxiety adds to the complexity of PD, lowering patients' quality of life. Future research can be directed to identify reactive and organic nature of anxiety in PD. (C) 2010 Movement Disorder Society