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帕金森病患者共病焦虑和惊恐障碍的患病率及临床关联

Prevalence and Clinical Correlates of Comorbid Anxiety and Panic Disorders in Patients with Parkinson's Disease.

作者信息

Elefante Camilla, Brancati Giulio Emilio, Bacciardi Silvia, Mazzucchi Sonia, Del Prete Eleonora, Palermo Giovanni, Frosini Daniela, Bonuccelli Ubaldo, Ceravolo Roberto, Lattanzi Lorenzo, Maremmani Icro, Perugi Giulio

机构信息

2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy.

Neurological Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy.

出版信息

J Clin Med. 2021 May 25;10(11):2302. doi: 10.3390/jcm10112302.

Abstract

Mood and anxiety disorders are the most common neuropsychiatric syndromes associated with Parkinson's disease (PD). The aim of our study was to estimate the prevalence of lifetime and current anxiety disorders in patients with Parkinson's Disease (PD), to explore possible distinctive neurological and psychiatric features associated with such comorbidity. One hundred patients were consecutively recruited at the Movement Disorders Section of the Neurological Outpatient Clinic of the University of Pisa. According to the MINI-Plus 5.0.0, 41 subjects were diagnosed with lifetime anxiety disorder (22 with panic disorder) and 26 were diagnosed with current anxiety disorders. Patients with anxiety disorders were more frequently characterized by psychiatric symptoms preceding PD, lifetime major depression and antidepressant treatments. They showed more anxious temperamental traits and scored higher at Parkinson Anxiety Scale (PAS) and persistent anxiety subscale. Current anxiety disorders were associated with more severe psychopathology, depressive symptomatology, and avoidant behavior. Among anxiety subtypes, patients with lifetime panic disorder showed higher rates of psychiatric symptoms before PD, lifetime unipolar depression, current psychiatric treatment, and a more severe psychopathology. Given the overall high impact of anxiety on patients' quality of life, clinicians should not underestimate the extent of different anxiety dimensions in PD.

摘要

情绪和焦虑障碍是与帕金森病(PD)相关的最常见神经精神综合征。我们研究的目的是估计帕金森病(PD)患者终生及当前焦虑障碍的患病率,探讨与此种共病相关的可能独特的神经学和精神特征。在比萨大学神经科门诊的运动障碍科连续招募了100名患者。根据MINI-Plus 5.0.0,41名受试者被诊断为终生焦虑障碍(22名患有惊恐障碍),26名被诊断为当前焦虑障碍。焦虑障碍患者更常具有帕金森病之前的精神症状、终生重度抑郁症和抗抑郁治疗史。他们表现出更多焦虑气质特征,在帕金森焦虑量表(PAS)和持续性焦虑子量表上得分更高。当前焦虑障碍与更严重的精神病理学、抑郁症状和回避行为相关。在焦虑亚型中,终生患有惊恐障碍的患者在帕金森病之前出现精神症状、终生单相抑郁症、当前接受精神治疗的比例更高,且精神病理学更严重。鉴于焦虑对患者生活质量的总体重大影响,临床医生不应低估帕金森病中不同焦虑维度的程度。

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