Prevalence of anxiety disorders and anxiety subtypes in patients with Parkinson's disease.
Anxiety disorders are common in Parkinson's disease (PD), but are not well characterized. This study determined the prevalence and clinical correlates of all DSM-IV-TR anxiety disorder diagnoses in a sample of 127 subjects with idiopathic PD who underwent comprehensive assessments administered by a psychiatrist and neurologist. A panel of six psychiatrists with expertise in geriatric psychiatry and/or movement disorders established by consensus all psychiatric diagnoses. Current and lifetime prevalence of at least one anxiety disorder diagnosis was 43% (n = 55) and 49% (n = 63), respectively. Anxiety disorder not otherwise specified, a DSM diagnosis used for anxiety disturbances not meeting criteria for defined subtypes, was the most common diagnosis (30% lifetime prevalence, n = 38). Compared with nonanxious subjects, panic disorder (n = 13) was associated with earlier age of PD onset [50.3 (12.2) vs. 61.0 (13.7) years, P < 0.01], higher rates of motor fluctuations [77% (10/13) vs. 39% (25/64), P = 0.01] and morning dystonia [38% (5/13) vs. 13% (8/62), P < 0.03]. This high prevalence of anxiety disorders, including disturbances often not meeting conventional diagnostic criteria, suggests that anxiety in PD is likely underdiagnosed and undertreated and refined characterization of anxiety disorders in PD is needed. In addition, certain anxiety subtypes may be clinically useful markers associated with disease impact in PD.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Gregory M
GM
Pontone
James R
JR
Williams
Karen E
KE
Anderson
Gary
G
Chase
Susanne A
SA
Goldstein
Stephen
S
Grill
Elaina S
ES
Hirsch
Susan
S
Lehmann
John T
JT
Little
Russell L
RL
Margolis
Peter V
PV
Rabins
Howard D
HD
Weiss
Laura
L
Marsh
D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000145:classification* / Q000453:epidemiology* / Q000209:etiology; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications; D015995:Prevalence