Depression and anxiety related subtypes in Parkinson's disease
Open accessAbstract
BACKGROUND: Depression and anxiety are common in Parkinson's disease (PD) and although clinically important remain poorly understood and managed. To date, research has tended to treat depression and anxiety as distinct phenomena. There is growing evidence for heterogeneity in PD in the motor and cognitive domains, with implications for pathophysiology and outcome. Similar heterogeneity may exist in the domain of depression and anxiety. OBJECTIVE: To identify the main anxiety and depression related subtype(s) in PD and their associated demographic and clinical features. METHODS: A sample of 513 patients with PD received a detailed assessment of depression and anxiety related symptomatology. Latent Class Analysis (LCA) was used to identify putative depression and anxiety related subtypes. Results LCA identified four classes, two interpretable as 'anxiety related': one anxiety alone (22.0%) and the other anxiety coexisting with prominent depressive symptoms (8.6%). A third subtype (9%) showed a prominent depressive profile only without significant anxiety. The final class (60.4%) showed a low probability of prominent affective symptoms. The validity of the four classes was supported by distinct patterns of association with important demographic and clinical variables. CONCLUSION: Depression in PD may manifest in two clinical phenotypes, one 'anxious-depressed' and the other 'depressed'. However, a further large proportion of patients can have relatively isolated anxiety. Further study of these putative phenotypes may identify important differences in pathophysiology and other aetiologically important factors and focus research on developing more targeted and effective treatment.
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Depression and anxiety are the most prevalent non-motor symptoms in Parkinson's disease.
“Psychological difficulties, especially depression and anxiety, are the most prevalent non-motor symptoms in Parkinson’s disease.”
From Distant delivery of a mindfulness-based intervention for people with Parkinson's disease: The study protocol of a randomised pilot trial (2017) · cites this paper as [4]
Up to 31% of people with Parkinson's disease report some level of anxiety.
“up to 31% of people with PD report some level of anxiety [4]”
From Distant delivery of a mindfulness-based intervention for people with Parkinson's disease: The study protocol of a randomised pilot trial (2017) · cites this paper as [4]
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Self-citationClinical Markers of Anxiety Subtypes in Parkinson Disease
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Self-citationAnxiety Has Specific Syndromal Profiles in Parkinson Disease: A Data-Driven Approach
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Components of Depression in Parkinson Disease
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Personalized Telemedicine for Depression in Parkinson’s Disease: A Pilot Trial
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The role of social support in anxiety and depression among Parkinson’s disease patients
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Screening for Anxiety Symptoms in Parkinson Disease
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Therapeutic Strategies to Treat or Prevent Off Episodes in Adults with Parkinson’s Disease
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Treatment of Nonmotor Symptoms Associated with Parkinson Disease
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Self-citationNonmotor Subtyping in Parkinson's Disease
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Self-citationImpact of depression on gait variability in Parkinson’s disease
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Rumination and behavioural factors in Parkinson's disease depression
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Self-citationCognitive Function in Parkinson’s Disease Patients with and without Anxiety
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Management of anxiety and motor symptoms in Parkinson’s disease
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Drug treatments for the neuropsychiatric complications of Parkinson’s disease
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‘Signposts on the journey’; medication adherence and the lived body in men with Parkinson's disease
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Self-citationClinical Presentation of Anxiety in Parkinson’s Disease
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Clinically relevant connectivity features define three subtypes of Parkinson's disease patients
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Phenomenology of Atypical Anxiety Disorders in Parkinson's Disease: A Systematic Review
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Neuropsychological and Emotional Correlates of Personality Traits in Parkinson’s Disease
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Circadian rhythm disruption: a potential trigger in Parkinson’s disease pathogenesis
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Ageing, masculinity and Parkinson's disease: embodied perspectives
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Self-citationNon-Pharmacological Interventions for Depression and Anxiety in Parkinson’s Disease
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Hurt, C. S., Alkufri, F., Brown, R. G., Burn, D. J., Hindle, J. V., Landau, S., Wilson, K., Samuel, M., & on behalf of the PROMS-PD study group (see acknowledgements) (2014) · Journal of Parkinson s Disease · doi:10.3233/jpd-130314 · Cited by 19 · see citing works
Self-citationPsychiatric Conditions in Parkinson Disease
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Elefante, C., Brancati, G. E., Bacciardi, S., Mazzucchi, S., Prete, E. D., Palermo, G., Frosini, D., Bonuccelli, U., Ceravolo, R., Lattanzi, L., et al. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10112302 · Cited by 18 · see citing works
- Authors
- Brown, R. G., Landau, S., Hindle, J. V., Playfer, J., Samuel, M., Wilson, K. C., Hurt, C. S., Anderson, R. J., Carnell, J., Dickinson, L., Gibson, G., van Schaick, R., Sellwood, K., Thomas, B. A., Burn, D. J., & for the PROMS-PD Study Group
- Affiliations
- King's College London (GB)
- Betsi Cadwaladr University Health Board (GB)
- University of Liverpool (GB)
- East Kent Hospitals University NHS Foundation Trust (GB)
- Newcastle University (GB)
- University of Newcastle Australia (AU)
- Corresponding author
- Brown, R. G.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2011-01-08
- Volume
- 82
- Issue
- 7
- Pages
- 803-809
- ISSN
- 0022-3050 (ISSN-L)
- OpenAlex
- W2098148677
- Cited by
- 183
- References
- 45
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 13 · 2023: 7 · 2022: 11 · 2021: 11 · 2020: 15 · 2019: 8 · 2018: 11 · 2017: 11 · 2016: 19 · 2015: 13 · 2014: 12 · 2013: 16 · 2012: 13
- FWCI
- 9.94
- Type
- journal article
- Language
- en
- Open access
- green
- hal.science
- Licence
- other-oa
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, public-domain)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Parkinson's UK (J-0601)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- Parkinson's disease, depression, anxiety, depressive phenotype, psychiatric comorbidity, latent class analysis, clinical phenotype
- MeSH terms
- Aged, Anxiety, Cognition Disorders, Depression, Female, Humans, Longitudinal Studies, Male, Middle Aged, Parkinson Disease, Predictive Value of Tests, Psychiatric Status Rating Scales, Socioeconomic Factors, Reproducibility of Results, Multivariate Analysis, Cluster Analysis, Logistic Models
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