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Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis.

Landau S, Harris V, Burn DJ, Hindle JV, Hurt CS, Samuel M, Wilson KC, Brown RG - Psychol Med (2015)

Bottom Line: LTA identified four classes, a 'Psychologically healthy' class (approximately 50%), and three classes associated with psychological distress: one with moderate anxiety alone (approximately 20%), and two with moderate levels of depression plus moderate or severe anxiety.Those with younger age of onset were also more likely to become distressed over the course of the study.Psychopathology was characterized by relatively stable anxiety or anxious-depression over the 4-year period.

View Article: PubMed Central - PubMed

Affiliation: Department of Biostatistics,Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK.

ABSTRACT

Background: Depression and anxiety in Parkinson's disease are common and frequently co-morbid, with significant impact on health outcome. Nevertheless, management is complex and often suboptimal. The existence of clinical subtypes would support stratified approaches in both research and treatment.

Method: Five hundred and thirteen patients with Parkinson's disease were assessed annually for up to 4 years. Latent transition analysis (LTA) was used to identify classes that may conform to clinically meaningful subgroups, transitions between those classes over time, and baseline clinical and demographic features that predict common trajectories.

Results: In total, 64.1% of the sample remained in the study at year 4. LTA identified four classes, a 'Psychologically healthy' class (approximately 50%), and three classes associated with psychological distress: one with moderate anxiety alone (approximately 20%), and two with moderate levels of depression plus moderate or severe anxiety. Class membership tended to be stable across years, with only about 15% of individuals transitioning between the healthy class and one of the distress classes. Stable distress was predicted by higher baseline depression and psychiatric history and younger age of onset of Parkinson's disease. Those with younger age of onset were also more likely to become distressed over the course of the study.

Conclusions: Psychopathology was characterized by relatively stable anxiety or anxious-depression over the 4-year period. Anxiety, with or without depression, appears to be the prominent psychopathological phenotype in Parkinson's disease suggesting a pressing need to understanding its mechanisms and improve management.

No MeSH data available.


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Estimated profiles of depression- and anxiety-related Parkinson's disease latenttransition analysis classes.
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fig02: Estimated profiles of depression- and anxiety-related Parkinson's disease latenttransition analysis classes.

Mentions: Interpretation of the LTA model was based on examination of the symptom profiles for thefour latent classes (see Fig. 2). The first class(open circles) represents a high predicted probability (0.60–1.00) of anxiety symptoms,particularly subjective tension and worry, symptoms of generalized anxiety/panic,autonomic symptoms of anxiety, irritability and poor concentration. Other common symptoms(probability 0.40–0.59) included fatigue, depressed mood, crying, indecisiveness andslowed thinking. This class is labelled ‘High anxiety + depression’. Class 2 (solidcircles), shows a similar profile but with lower probabilities of the main anxiety-relatedsymptoms and is labelled ‘Moderate anxiety + depression’. Class 3 (open squares) ischaracterized mainly by moderate probabilities of anxiety symptoms without evidentdepression and is labelled ‘Moderate anxiety’. Finally, class 4 (solid squares) wascharacterized by low probability of any prominent symptoms and labelled ‘Psychologicallyhealthy’. Fig. 2.


Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis.

Landau S, Harris V, Burn DJ, Hindle JV, Hurt CS, Samuel M, Wilson KC, Brown RG - Psychol Med (2015)

Estimated profiles of depression- and anxiety-related Parkinson's disease latenttransition analysis classes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697304&req=5

fig02: Estimated profiles of depression- and anxiety-related Parkinson's disease latenttransition analysis classes.
Mentions: Interpretation of the LTA model was based on examination of the symptom profiles for thefour latent classes (see Fig. 2). The first class(open circles) represents a high predicted probability (0.60–1.00) of anxiety symptoms,particularly subjective tension and worry, symptoms of generalized anxiety/panic,autonomic symptoms of anxiety, irritability and poor concentration. Other common symptoms(probability 0.40–0.59) included fatigue, depressed mood, crying, indecisiveness andslowed thinking. This class is labelled ‘High anxiety + depression’. Class 2 (solidcircles), shows a similar profile but with lower probabilities of the main anxiety-relatedsymptoms and is labelled ‘Moderate anxiety + depression’. Class 3 (open squares) ischaracterized mainly by moderate probabilities of anxiety symptoms without evidentdepression and is labelled ‘Moderate anxiety’. Finally, class 4 (solid squares) wascharacterized by low probability of any prominent symptoms and labelled ‘Psychologicallyhealthy’. Fig. 2.

Bottom Line: LTA identified four classes, a 'Psychologically healthy' class (approximately 50%), and three classes associated with psychological distress: one with moderate anxiety alone (approximately 20%), and two with moderate levels of depression plus moderate or severe anxiety.Those with younger age of onset were also more likely to become distressed over the course of the study.Psychopathology was characterized by relatively stable anxiety or anxious-depression over the 4-year period.

View Article: PubMed Central - PubMed

Affiliation: Department of Biostatistics,Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK.

ABSTRACT

Background: Depression and anxiety in Parkinson's disease are common and frequently co-morbid, with significant impact on health outcome. Nevertheless, management is complex and often suboptimal. The existence of clinical subtypes would support stratified approaches in both research and treatment.

Method: Five hundred and thirteen patients with Parkinson's disease were assessed annually for up to 4 years. Latent transition analysis (LTA) was used to identify classes that may conform to clinically meaningful subgroups, transitions between those classes over time, and baseline clinical and demographic features that predict common trajectories.

Results: In total, 64.1% of the sample remained in the study at year 4. LTA identified four classes, a 'Psychologically healthy' class (approximately 50%), and three classes associated with psychological distress: one with moderate anxiety alone (approximately 20%), and two with moderate levels of depression plus moderate or severe anxiety. Class membership tended to be stable across years, with only about 15% of individuals transitioning between the healthy class and one of the distress classes. Stable distress was predicted by higher baseline depression and psychiatric history and younger age of onset of Parkinson's disease. Those with younger age of onset were also more likely to become distressed over the course of the study.

Conclusions: Psychopathology was characterized by relatively stable anxiety or anxious-depression over the 4-year period. Anxiety, with or without depression, appears to be the prominent psychopathological phenotype in Parkinson's disease suggesting a pressing need to understanding its mechanisms and improve management.

No MeSH data available.


Related in: MedlinePlus