Coping and quality of life of patients with Parkinson disease who have undergone deep brain stimulation of the subthalamic nucleus.
BACKGROUND
Although the positive effect of DBS of the STN on motor signs and mobility in PD is indisputable, the effect on mental health (depression and anxiety) as well as on QoL is subject to more debate. Some works have already shown that coping strategies have an impact on QoL, depression, and anxiety. To date, no studies have examined the coping strategies used by patients with PD who undergo STN stimulation. We decided to investigate the coping strategies of patients with PD who have undergone an STN DBS and their relationship with QoL while taking depression and anxiety into account.


METHODS
A total of 40 patients stimulated for 12 months and 40 patients under dopatherapy were compared. The 2 groups were matched according to age, sex, age at disease onset, severity of disease, motor scores, daily treatment dosage, and professional status. Semistructured interviews were carried out, after which, their mental and cognitive states were assessed using different scales (MINI, MADRS, EHD, HAMA, FAB). Finally, all subjects completed 3 self-report questionnaires: 2 assessing coping strategies (WCC, CHIP), and 1, QoL the Parkinson Disease Questionnaire (PDQ-39).


RESULTS
Depression and anxiety were not significantly influenced by the type of treatment. Concerning coping strategies, we found a significant effect of the stimulation on instrumental strategies with higher scores for patients under dopatherapy. As for QoL, the only difference concerned communication with a poorer QoL for stimulated patients. We noted no significant correlations between any coping strategies and all of the dimensions of QoL in the stimulated group, whereas we found the opposite result for the dopatherapy group.


CONCLUSIONS
These results encourage us to prepare patient candidates for such stimulation by developing interventions focused first on their expectations and second, on their coping strategies.
Montel
Sébastien Robert
SR
Laboratory of Clinical Psychopathology and Neuropsychology, University Paris Descartes, France. montel.sebastien@wanadoo.fr
Bungener
Catherine
C
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology; D003071:Cognition; D046690:Deep Brain Stimulation / Q000009:adverse effects; D003863:Depression / Q000209:etiology; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D010353:Patient Education as Topic; D011597:Psychomotor Performance; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors
D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D007980:Levodopa