Cited by 103Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesParkinson's Disease Mechanisms and TreatmentsDeep Brain Stimulation and Movement Disorders

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Generalized anxiety disorder and the Hamilton Anxiety Rating Scale in Parkinson's disease

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Kummer, Arthur, Cardoso, Francisco, Teixeira, Antonio Lucio·2010·Arquivos de Neuro-Psiquiatria

DOI 10.1590/s0004-282x2010000400005

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Abstract

UNLABELLED: Anxiety is common in Parkinson's disease (PD), but studies concerning specific anxiety disorders are scarce. Essential psychometric properties of anxiety rating scales are also lacking. OBJECTIVE: To investigate general anxiety disorder (GAD) in PD and psychometric properties of the Hamilton Anxiety Rating Scale (Ham-A). METHOD: Ninety-one PD patients underwent neurological and psychiatric examination, which included the MINI-Plus, the Ham-A and the Hamilton Depression Rating Scale (Ham-D). RESULTS: GAD was present in 30.8% of PD patients. Patients with GAD had longer disease duration (p=0.044) and were in use of higher doses of levodopa (p=0.034). They also tended to have more motor fluctuations and dyskinesias. The group with GAD scored higher in Ham-A (p<0.001), in the somatic (p=0.004) and psychic (p<0.001) subscales of Ham-A, and in Ham-D (p=0.004). The Ham-A showed good internal consistency (Cronbach's alpha=0.893) and a cutoff score of 10/11 is suggested to screen for GAD. CONCLUSION: GAD is frequent in PD and the Ham-A may be a useful instrument to screen for this disorder.

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“The psychological scores (Hamilton Anxiety Scale) before and after treat-ment were compared between the two groups [16].”
Personality and Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease
Daga, G. A., Marzola, E., Amianto, F., Zibetti, M., Merola, A., Lanotte, M., Lopiano, L., & Fassino, S. (2014) · International Neuropsychiatric Disease Journal · doi:10.9734/indj/2014/11740 · Cited by 3
“89 [41] and its test-retest reliability was good [42].”
Background
Efetividade da fisioterapia associada à musicoterapia na doença de Parkinson
Yamashita, F. C., Saito, T. C., de Almeida, I. A., Barboza, N. M., & Santos, S. M. S. (2013) · ConScientiae Saúde · doi:10.5585/conssaude.v11n4.3857 · Cited by 3
Parkinson Hastalığında Cinsel İşlev Bozukluklarının Kadın ve Erkek Hastalarda Belirleyicileri / Predictors of Sexual Dysfunction in Female and Male Patients with Idiopathic Parkinson’s Disease
Atagün, M. İ., Atmaca, B., Özer, F., Özben, S., Tıraş, R., Çetin, S. E., & GENÇ, M. F. (2012) · Dusunen Adam The Journal of Psychiatry and Neurological Sciences · doi:10.5350/dajpn2013260103 · Cited by 3
The effect of mindfulness and metacognition on anxiety symptoms: a case-control study
Aydın, O., Obuća, F., Çakıroğlu, E., Ünal‐Aydın, P., & Esen-Danacı, A. (2022) · Middle East Current Psychiatry · doi:10.1186/s43045-022-00260-7 · Cited by 4
“89; [52]) and good inter-rater reliability as determined by an intra-class correlation coefficient of 0.”
Method
Instruments to assess anxiety symptoms in brazilian population and the case of the Spence Children's Anxiety Scale (SCAS) : cross-cultural adaptation and psychometric properties
DeSousa, D. A. (2013) · Americanae (AECID Library) · Cited by 3
Prevalence of anxiety and depression in migraine or tension type headache in patients with or without vertigo
Phalgune Deepak, S., Govind, V., Sudhir, K., & Premendrakumar, S. (2019) · IP Indian Journal of Neurosciences · doi:10.18231/j.ijn.2019.005 · Cited by 2
Validity and reliability of the agentive steadfastness index
Vosloo, C., & van Staden, W. (2023) · International Journal of Psychology · doi:10.1002/ijop.13098 · Cited by 3
Allelic variant in SLC6A3 rs393795 affects cerebral regional homogeneity and gait dysfunction in patients with Parkinson’s disease
Wang, L., Yuan, Y., Wang, J., Shen, Y., Zhi, Y., Li, J., Wang, M., & Zhang, K. (2019) · PeerJ · doi:10.7717/peerj.7957 · Cited by 2
Efeito agudo da marcha em esteira com estímulo auditivo sobre parâmetros cinemáticos da marcha e mobilidade em Parkinsonianos
Yamada, P. D. A., Amaral-Felipe, K. M., Rodrigues, B. F., Cursino, M. P., Hallal, C. Z., & Faganello-Navega, F. R. (2016) · Motricidade · doi:10.6063/motricidade.7875 · Cited by 2
Nurses' Knowledge of Signs and Symptoms of Anxiety and AgitationPreprint
DiSano, C. (2015) · doi:10.28971/532015dc75 · Cited by 2
“In this study, the reliability of the HAM-A was 0.893, supportive of good internal consistency for use of the HAM-A as a tool to assess anxiety in patients with PD (Kummer et al., 2010).”
MethodInfluential
The efficacy of acupuncture for generalized anxiety disorder (GAD) in college students: Study protocol for a randomized controlled trial
Wang, Y., Gu, X., Zhi, B., Yan, Y., Lu, F., Hu, H.-T., & Zhang, Q. (2025) · PLoS ONE · doi:10.1371/journal.pone.0316804 · Cited by 2
The impact of online brain-spotting therapy on brain metabolism and PTSD symptoms of intimate sexual violence victims: a single case study
Foo, M., Himawan, K. K., & Susanto, E. (2025) · Mental Health Review Journal · doi:10.1108/mhrj-01-2024-0003
Anxiety in Parkinson’s Disease
Dissanayaka, N. N. (2021) · Cambridge University Press eBooks · doi:10.1017/9781139087469.009 · Cited by 1
Anxiety and Comorbidities Differences in Adults with Chronic Pulmonary Diseases: Serbian Single Center Experience
Mujović, N., Popovic, K., Janković, J., Mijatov, S. P., Mujović, N., Bogdanović, J. M., Stjepanović, M., Nikčević, L., Radosavljevic, N., & Nikolić, D. (2022) · Medicina · doi:10.3390/medicina58030392 · Cited by 1
“In our study we assessed separately: psychic component with psychic subscale (questions 1–6 and question 14) and somatic component by somatic subscale (questions 7–13) [20].”
Method
Generalized anxiety causing globus pharyngeus
Thejas, S. R., Sharanya, J., & Rajamohan, G. (2023) · MRIMS Journal of Health Sciences · doi:10.4103/mjhs.mjhs_72_22 · Cited by 1
Prevalence and Risk Factors of Psychiatric Symptoms among Type 2 Diabetes Mellitus Patients in South India: A Cross-Sectional Study.
Utchimahali, S., Kannan, S., & Velayutham, K. (2024) · International Journal of Innovative Science and Research Technology (IJISRT) · doi:10.38124/ijisrt/ijisrt24aug927 · Cited by 1
Transtornos de ansiedade na doença de Parkinson: Estudo de validação da Parkinson Anxiety Scale (PAS) e associação com o sistema endocanabinóide
Vieira, J. C. F. (2020) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.17.2020.tde-11022020-153242 · Cited by 1
INDUÇÃO DE HUMOR POR REALIDADE VIRTUAL
BERNARDO, P. D. (2019) · doi:10.17771/pucrio.acad.46847 · Cited by 1
Ocorrência de sintomas depressivos e de ansiedade em fibromiálgicos
de Toledo, C. V., Antunes, M. D., Nishida, F. S., & de Oliveira, L. P. (2022) · Saúde e Desenvolvimento Humano · doi:10.18316/sdh.v10i1.8102
A Policy Analysis of the Provisions of the Patient Protection and Affordable Care Act Related to Access to Primary Care for Older AdultsPreprint
Fontaine, T. (2015) · doi:10.28971/532015ft149
Religiosität, magisches Denken und paranormale Vorstellungen bei Patienten mit Angst- und Zwangsstörungen
Metscher, T. (2013)
Specific neuropsychiatric disorders
Aarsland, D., Cummings, J. L., Weintraub, D., & Chaudhuri, К. R. (2013) · Cambridge University Press eBooks · doi:10.1017/cbo9781139856669.011
Psychoneuroimmunology and Chronic Pain
Giron, S. E. (2015) · doi:10.22371/07.2015.016
Efetividade da fisioterapia associada à musicoterapia na doença de Parkinson Effectiveness of physiotherapy associated with a music therapy in Parkinson's disease
Yamashita, F. C., Saito, T. C., de Almeida, I. A., Mahmoud, S., & Santos, S. (2012)
Music Therapy for Preoperative Anxiety in Surgical Patients: An Integrative ReviewPreprint
Deuel, A. (2018) · doi:10.28971/532018da96
Relações entre ocitocina, apego e sono em pessoas com Transtorno de Ansiedade Generalizada
Vale, E. A. N. (2019) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.47.2019.tde-16082019-110304
Eficácia da terapia comportamental baseada em aceitação em grupo para o transtorno de ansiedade generalizada: um ensaio clínico aleatorizado
Sampaio, T. P. D. A. (2020) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.47.2020.tde-28052020-192438
Melhorando o diagnóstico de dermatotilexomania entre brasileiros: validação da Escala de Impacto de Dermatotilexomania e desenvolvimento de uma medida fotográfica
Xavier, A. C. M., de Souza, C. M. B., Flores, L. H. F., Prati, C., Cassal, C., & Dreher, C. B. (2019) · Anais Brasileiros de Dermatologia · doi:10.1016/j.abdp.2018.10.003
“Episódio depressivo atual 16 (25,4) Episódio depressivo passado 13 (20,6) Distimia 4 (6,3) Transtorno afetivo bipolar 6 (9,5) Transtorno de pânico 18 (28,6) Agorafobia 10 (15,9) Ansiedade social 6 (9,5)”
Avaliação em idosos: uma investigação sobre instrumentos de medida
da Silva, A. C. (2021) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/d.100.2021.tde-13052021-210249
Marcadores inflamatórios na terapia comportamental baseada em aceitação e atenção plena em pacientes com transtorno de ansiedade generalizada
Gandarela, L. M. (2021) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2021.tde-08122021-140003
Efeito Imediato da Fisioterapia na Marcha em Indivíduos com Doença de Parkinson
de Almeida, I. A., do Nascimento, T. S., Lemes, L. B., Batistetti, C. L., Ferraz, H. B., & Santos, S. M. S. (2015) · Saúde e Pesquisa · doi:10.17765/1983-1870.2015v8n2p247-253
Anxiety
Marsh, L., & Calleo, J. (2013) · Cambridge University Press eBooks · doi:10.1017/cbo9781139856669.012
Effect of Transcranial Direct Current Stimulation in Acute Anxiety and Cognitive Performance of Athletes: an Experimental, Double-Blind, Randomized Study
de Oliveira, R. V., Moura, H. S., de Sousa, J. O., Schuelter‐Trevisol, F., & Trevisol, D. J. (2024) · Journal of Health Sciences · doi:10.17921/2447-8938.2024v26n2p106-114
Analysis of the application value of the Roy Adaptation Model in Parkinson's disease nursing care: A non-blinded, single-center observational study
Xu, Y.-L., Hu, Y., Luo, N., Sun, L., Xiao, X., Tang, L., & Li, Y. (2025) · Clinics · doi:10.1016/j.clinsp.2025.100820
Additional file 1 of Effect of MDMA-assisted therapy on mood and anxiety symptoms in advanced-stage cancer (EMMAC): study protocol for a double-blind, randomised controlled trial
Bhagavan, C., Glue, P., Evans, W., Reynolds, L., Turner, T., King, C., Russell, B. R., Morunga, E., Mills, J. L., Layton, G., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25876232
Additional file 2 of Effect of MDMA-assisted therapy on mood and anxiety symptoms in advanced-stage cancer (EMMAC): study protocol for a double-blind, randomised controlled trial
Bhagavan, C., Glue, P., Evans, W., Reynolds, L., Turner, T., King, C., Russell, B. R., Morunga, E., Mills, J. L., Layton, G., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25876328
Additional file 3 of Effect of MDMA-assisted therapy on mood and anxiety symptoms in advanced-stage cancer (EMMAC): study protocol for a double-blind, randomised controlled trial
Bhagavan, C., Glue, P., Evans, W., Reynolds, L., Turner, T., King, C., Russell, B. R., Morunga, E., Mills, J. L., Layton, G., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26723801
Utility of the SEND-PD Scale in Parkinson’s Disease: A Narrative Review
Hussain, J. M., Mubeen, M., Khan, S. M., Alauddin, S., Athar, F. B., Ellahi, D. M., Ali, Q., Khan, S. R., & Saleem, Z. (2025) · Brain Science Advances · doi:10.26599/bsa.2025.905004
“[9], panic disorder (22%), apathy (12.7%), and depression (13”
Influential
Evaluating a Dual Digital Cognitive Behavioral Therapy and Health & Wellness Coaching Intervention for Anxiety and Depression: Pilot Study (Preprint)Preprint
Kirk, A., King, C. S., Gallop, R., Doan, B. D., Rowe, L. S., Rivera, M., & Randa, L. E. (2026) · doi:10.2196/preprints.92448
Correlation of Vitamin B12, homocysteine, and folate with sleep quality in obsessive-compulsive disorder: A cross-sectional study
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Enhancing gait training with anti-gravity treadmill ‘Alter-G’ in patients with Parkinson’s disease
Latella, D., Facciale, A. L., Bonanno, M., Bonanno, L., Leo, A., Cellini, R., Lorenzo, G. D., Buonasera, P., Formica, C., Paladina, G., et al. (2026) · PLoS ONE · doi:10.1371/journal.pone.0341021
“Higher scores indicate greater severity of anxiety symptoms [25].”
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Increased brain-derived neurotrophic factor following successful psychological treatment in generalized anxiety disorder: a randomized clinical trial
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“The Brazilian Portuguese adapted version [17] of the Hamilton Anxiety Scale (HAM-A) [18] was used to measure the severity of anxiety symptoms.”
Evaluating a Dual Digital Cognitive Behavioral Therapy and Health and Wellness Coaching Intervention for Anxiety and Depression: Single-Arm Pilot Study
Kirk, A., King, C. S., Gallop, R., Doan, B. D., Rowe, L. S., & Randa, L. E. (2026) · JMIR Human Factors · doi:10.2196/92448
“The HAM-A has demonstrated good internal consistency (α=.89) [51].”

Authors: Kummer, A., Cardoso, F., & Teixeira, A. L.
Affiliations: Federal University of Minas Gerais, Brazil
Universidade Federal de Minas Gerais (BR)
Federal University of Minas Gerais, Brazil; UFMG
ORCID: Cardoso, Francisco
Venue: Arquivos de Neuro-Psiquiatria
Publisher: FapUNIFESP (SciELO)
Published: 2010-08
Volume: 68
Issue: 4
Pages: 495-501
ISSN: 0004-282X (ISSN-L)
DOI: 10.1590/s0004-282x2010000400005
OpenAlex: W2000777554
Cited by: 103
References: 36
Citations by year: 2026: 7 · 2025: 5 · 2024: 12 · 2023: 2 · 2022: 7 · 2021: 10 · 2020: 10 · 2019: 10 · 2018: 3 · 2017: 4 · 2016: 7 · 2015: 8 · 2014: 6 · 2013: 8 · 2012: 3
FWCI: 5.01
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc
Locations: Arquivos de Neuro-Psiquiatria (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
Americanae (AECID Library) (submittedVersion, other-oa)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Conselho Nacional de Desenvolvimento Científico e Tecnológico
Fundação de Amparo à Pesquisa do Estado de Minas Gerais
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
Keywords: generalized anxiety disorder, Parkinson's disease, Hamilton Anxiety Rating Scale, psychometric properties, anxiety screening, levodopa dose, motor fluctuations, dyskinesia, depression, internal consistency
MeSH terms: Anxiety Disorders, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Parkinson Disease, Psychiatric Status Rating Scales, Psychometrics, ROC Curve, Sensitivity and Specificity

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Generalized anxiety disorder and the Hamilton Anxiety Rating Scale in Parkinson's disease

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