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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.


Related in: MedlinePlus

Estimated proportions (%) of latent transition analysis class membership at eachtime-point.
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fig03: Estimated proportions (%) of latent transition analysis class membership at eachtime-point.

Mentions: Fig. 3 shows the estimated marginal proportionsof the four classes at each time-point. The ‘Psychologically healthy’ class was mostcommon, followed by the ‘Moderate anxiety’ class, and two anxious and depressed classes.There was a trend towards an increase in the combined depression-related classes, from15.1% at baseline to 19.5–21.1% in subsequent years, while the ‘Moderate anxiety’ classshowed a corresponding decrease. Fig. 3.


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 proportions (%) of latent transition analysis class membership at eachtime-point.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig03: Estimated proportions (%) of latent transition analysis class membership at eachtime-point.
Mentions: Fig. 3 shows the estimated marginal proportionsof the four classes at each time-point. The ‘Psychologically healthy’ class was mostcommon, followed by the ‘Moderate anxiety’ class, and two anxious and depressed classes.There was a trend towards an increase in the combined depression-related classes, from15.1% at baseline to 19.5–21.1% in subsequent years, while the ‘Moderate anxiety’ classshowed a corresponding decrease. Fig. 3.

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