RT Journal Article
SR Electronic
T1 Depression and anxiety related subtypes in Parkinson's disease
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 803
OP 809
DO 10.1136/jnnp.2010.213652
VO 82
IS 7
A1 Richard G Brown
A1 Sabine Landau
A1 John V Hindle
A1 Jeremy Playfer
A1 Michael Samuel
A1 Kenneth C Wilson
A1 Catherine S Hurt
A1 Rachel J Anderson
A1 Joanna Carnell
A1 Lucy Dickinson
A1 Grant Gibson
A1 Rachel van Schaick
A1 Katie Sellwood
A1 Bonnita A Thomas
A1 David J Burn
A1 for the PROMS-PD Study Group
YR 2011
UL http://jnnp.bmj.com/content/82/7/803.abstract
AB Background Depression and anxiety are common in Parkinson's disease (PD) and although clinically important remain poorly understood and managed. To date, research has tended to treat depression and anxiety as distinct phenomena. There is growing evidence for heterogeneity in PD in the motor and cognitive domains, with implications for pathophysiology and outcome. Similar heterogeneity may exist in the domain of depression and anxiety.Objective To identify the main anxiety and depression related subtype(s) in PD and their associated demographic and clinical features.Methods A sample of 513 patients with PD received a detailed assessment of depression and anxiety related symptomatology. Latent Class Analysis (LCA) was used to identify putative depression and anxiety related subtypes.Results LCA identified four classes, two interpretable as ‘anxiety related’: one anxiety alone (22.0%) and the other anxiety coexisting with prominent depressive symptoms (8.6%). A third subtype (9%) showed a prominent depressive profile only without significant anxiety. The final class (60.4%) showed a low probability of prominent affective symptoms. The validity of the four classes was supported by distinct patterns of association with important demographic and clinical variables.Conclusion Depression in PD may manifest in two clinical phenotypes, one ‘anxious–depressed’ and the other ‘depressed’. However, a further large proportion of patients can have relatively isolated anxiety. Further study of these putative phenotypes may identify important differences in pathophysiology and other aetiologically important factors and focus research on developing more targeted and effective treatment.