Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA.
Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO, USA.
J Geriatr Psychiatry Neurol. 2023 Nov;36(6):496-504. doi: 10.1177/08919887231163293. Epub 2023 Mar 9.
Parkinson's Disease (PD) affects over 10 million people worldwide. Many PD patients experience comorbid anxiety disorders, which have been correlated with reduced quality of life and can manifest at any time during the course of PD, including prior to motor symptom onset. Prior work has demonstrated that patients diagnosed with depression following a PD diagnosis are less likely to receive depression treatment, but no such study has been conducted for anxiety. A cross-sectional analysis of secondary electronhic health record data was conducted. Data was obtained through Optum® de-identified Electronic Health Record dataset, using ICD-9 and ICD-10 diagnosis codes to determine PD status and comparing index date of anxiety and PD diagnoses to classify patients by relative time of diagnosis. Multivariate logistic regression was performed to assess factors associated with receipt of mental health treatment. Of PD patients with anxiety, 52% documented a diagnosis of anxiety prior to PD. Overall, 69% documented some treatment, with 79% of those diagnosed with anxiety prior to PD receiving some treatment compared to 59% of those diagnosed with anxiety on or after PD ( < 0.001). Patients with PD and subsequent anxiety diagnoses are less likely to receive treatment. Further study could explore reasons for variations in mental health care within the context of an existing PD diagnosis.
帕金森病（PD）影响着全球超过 1000 万人。许多 PD 患者同时患有共病性焦虑障碍，这与生活质量降低有关，并且可能在 PD 病程中的任何时候出现，包括在运动症状出现之前。之前的研究表明，在 PD 诊断后被诊断为抑郁症的患者不太可能接受抑郁症治疗，但对于焦虑症却没有进行过此类研究。本研究对电子病历的二级数据进行了横断面分析。使用 Optum®去识别电子健康记录数据集，通过 ICD-9 和 ICD-10 诊断代码确定 PD 状态，并比较焦虑症和 PD 诊断的索引日期，以相对诊断时间对患者进行分类。采用多变量逻辑回归评估与接受心理健康治疗相关的因素。在有焦虑症的 PD 患者中，52%在 PD 之前有焦虑症的诊断记录。总体而言，69%有过治疗记录，其中在 PD 之前被诊断为焦虑症的患者中有 79%接受了治疗，而在 PD 之后被诊断为焦虑症的患者中只有 59%接受了治疗（<0.001）。患有 PD 且随后被诊断为焦虑症的患者更有可能不接受治疗。进一步的研究可以探索在现有的 PD 诊断背景下，心理健康护理方面差异的原因。
