title: Illness impact and adjustment to Parkinson's disease: before and after treatment with tolcapone.
abstract: Research on the impact of disease and treatment on health status and quality of life in patients with movement disorders is limited. We studied quality of life in 46 patients with Parkinson's disease (PD) to determine whether the impact of illness and psychosocial adjustment to illness were improved by 42 days of adjunctive therapy with tolcapone (50 mg, 200 mg, or 400 mg three times a day). This study was conducted in parallel with a double-blind, placebo-controlled, dose-response study of the safety and efficacy of tolcapone in combination with levodopa/carbidopa therapy. Only a subset of individuals from the larger study participated. In the quality of life study, illness impact and adjustment to illness were measured subjectively by the Sickness Impact Profile (SIP) and the Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR). Patient ratings of total illness impact (p = 0.003), physical illness impact (p = 0.05), and psychosocial illness impact (p = 0.007) improved significantly in individuals receiving tolcapone compared with those receiving placebo. There was no statistically significant difference in adjustment to illness when the tolcapone and placebo groups were compared; however, 17 of 21 adjustment to illness indicators showed improvement.
authors.affiliation: University of Southern California School of Medicine, Los Angeles, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Welsh
authors.forename: E
authors.initials: E
authors.lastname: Dorflinger
authors.forename: D
authors.initials: D
authors.lastname: Chernik
authors.forename: C
authors.initials: C
authors.lastname: Waters
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001577:Benzophenones / Q000009:adverse effects / Q000627:therapeutic use*; D002230:Carbidopa / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009596:Nitrophenols; D010300:Parkinson Disease / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D012803:Sick Role; D018434:Sickness Impact Profile; D000077867:Tolcapone; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D001577:Benzophenones; D009596:Nitrophenols; D007980:Levodopa; D000077867:Tolcapone; D002230:Carbidopa