School of Medicine, University of Belgrade, Serbia.
J Geriatr Psychiatry Neurol. 2013 Mar;26(1):34-40. doi: 10.1177/0891988713476368. Epub 2013 Feb 13.
A limited number of studies examined anxiety in Parkinson disease (PD). Questionable validity of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) defined anxiety disorders in PD population as well as a lack of validated rating scales hampered the investigation in this field.
To screen for prevalence of anxiety symptoms and their associated demographic and clinical features in an outpatient-based cohort with PD.
A consecutive series of 360 patients with PD underwent investigation with the Hamilton Anxiety Rating Scale (HARS), the 17-item Hamilton Depression Rating Scale, Neuropsychiatric Inventory, section E (anxiety), motor scoring with Hoehn and Yahr staging, the Unified Parkinson's Disease Rating Scale, and cognitive screening with the Mini-Mental State Examination.
In all, 136 (37.8%) patients with PD of our cohort had anxiety symptoms, whereas both depression and anxiety were recorded in 5.6% of the patients, while in 56.7% neither anxiety nor depression was present. Female gender, motor disability, and core depression symptoms were the main markers of anxiety in patients with PD. The severity of anxiety symptoms was not associated with asymmetry of motor symptoms. Education, disease duration, and levodopa dose were poor predictors in the model. The HARS had a satisfactory inter-item correlation, convergent validity, and factorial structure.
Anxiety may be present as an isolated symptom, with specific demographic and clinical markers, and not only as a feature of depression in PD population. This highlighted the importance of identifying anxiety symptoms when treating patients with PD.
已有少量研究探讨了帕金森病（PD）患者的焦虑问题。《精神障碍诊断与统计手册（第四版）》对焦虑障碍的定义存在争议，PD 患者中也缺乏经过验证的评定量表，这使得该领域的研究受到阻碍。
在一个基于门诊的 PD 患者队列中筛查焦虑症状的患病率及其相关的人口统计学和临床特征。
对连续的 360 例 PD 患者进行了 Hamilton 焦虑量表（HARS）、17 项 Hamilton 抑郁量表、神经精神问卷 E 项（焦虑）、Hoehn 和 Yahr 分期的运动评分、统一帕金森病评定量表和简易精神状态检查的认知筛查。
在我们的队列中，共有 136 例（37.8%）PD 患者存在焦虑症状，而 5.6%的患者同时存在抑郁和焦虑，56.7%的患者既无焦虑也无抑郁。女性、运动障碍和核心抑郁症状是 PD 患者焦虑的主要标志物。焦虑症状的严重程度与运动症状的不对称性无关。教育程度、疾病持续时间和左旋多巴剂量是模型中的不良预测因子。HARS 具有良好的项目间相关性、收敛效度和因子结构。
焦虑可能是 PD 患者的一种孤立症状，存在特定的人口统计学和临床标志物，而不仅仅是抑郁的特征。这强调了在治疗 PD 患者时识别焦虑症状的重要性。
