Department of Clinical Pharmacology, University Hospital, Toulouse, France.
Mov Disord. 2010 Jan 30;25(2):157-66. doi: 10.1002/mds.22760.
Anxiety has been less extensively studied than depression in Parkinson's disease (PD). The DoPaMiP survey allowed assessing simultaneously anxiety and depressive symptoms in PD and comparing correlations of both symptoms with clinical and therapeutic features of the disease. Cross sectional survey conducted prospectively in 450 ambulatory nondemented PD patients and 98 patients with other disorders than PD. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), parkinsonism using the Unified Parkinson's Disease Rating Scale (UPDRS). Other clinical factors were measured using a structured standardized examination/questionnaire. The mean HADS-A (anxiety) subscore was higher in PD patients than in the others (8.2 +/- 3.9 vs. 6.5 +/- 3.2, P < 10(-4)) as was the HADS-D (depressive) subscore (6.6 +/- 3.8 vs. 3.9 +/- 3.2, P < 10(-4)). Patients with possible/probable anxious signs (HADS-A >or= 8) were more prevalent in PD (51% vs. 29%, P < 10(-4)) as were those with depressive symptoms (40% vs. 10%, P < 10(-4)). Conversely, anxiolytic and antidepressant medications consumption was not different between the 2 groups. Patients with anxious symptoms were more frequently female and younger than those without such symptoms, while those with depressive symptoms had more severe indices of parkinsonism, more comorbidities and lower cognitive function (Mini Mental State Exam). The logistic regression model revealed that patients with depressive symptoms received more frequently levodopa and less frequently a dopamine agonist. Anxiety and depressive symptoms were more frequent in PD patients than in medical control group. Both symptoms were commonly associated in the same PD patients, but were correlated with different clinical/therapeutic features, suggesting different underlying pathophysiological mechanisms.
焦虑在帕金森病（PD）中的研究不如抑郁广泛。DoPaMiP 调查允许同时评估 PD 患者的焦虑和抑郁症状，并比较两种症状与疾病的临床和治疗特征的相关性。在 450 名非痴呆 PD 门诊患者和 98 名其他疾病患者中进行前瞻性横断面调查。使用医院焦虑和抑郁量表（HADS）评估焦虑和抑郁症状，使用统一帕金森病评定量表（UPDRS）评估帕金森病。使用结构化标准化检查/问卷测量其他临床因素。PD 患者的 HADS-A（焦虑）亚量表评分高于其他患者（8.2 +/- 3.9 与 6.5 +/- 3.2，P < 10(-4))，HADS-D（抑郁）亚量表评分也是如此（6.6 +/- 3.8 与 3.9 +/- 3.2，P < 10(-4))。有可疑/可能焦虑迹象的患者（HADS-A >or= 8）在 PD 中更为常见（51%与 29%，P < 10(-4))，有抑郁症状的患者也是如此（40%与 10%，P < 10(-4))。然而，两组之间的抗焦虑和抗抑郁药物的使用并无差异。有焦虑症状的患者比没有这种症状的患者更常见于女性和年轻患者，而有抑郁症状的患者则有更严重的帕金森病指数、更多的合并症和更低的认知功能（简易精神状态检查）。逻辑回归模型显示，有抑郁症状的患者更常接受左旋多巴治疗，而较少接受多巴胺激动剂治疗。PD 患者的焦虑和抑郁症状比医学对照组更为常见。两种症状在同一 PD 患者中常见，但与不同的临床/治疗特征相关，提示不同的潜在病理生理机制。
