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Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis

Lookup NU author(s): Professor David Burn


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Background Depression and anxiety in Parkinson's disease are common and frequently co-morbid, with significant impact on health outcome. Nevertheless, management is complex and often suboptimal. The existence of clinical subtypes would support stratified approaches in both research and treatment.Method Five hundred and thirteen patients with Parkinson's disease were assessed annually for up to 4 years. Latent transition analysis (LTA) was used to identify classes that may conform to clinically meaningful subgroups, transitions between those classes over time, and baseline clinical and demographic features that predict common trajectories.Results In total, 64.1% of the sample remained in the study at year 4. LTA identified four classes, a Psychologically healthy' class (approximately 50%), and three classes associated with psychological distress: one with moderate anxiety alone (approximately 20%), and two with moderate levels of depression plus moderate or severe anxiety. Class membership tended to be stable across years, with only about 15% of individuals transitioning between the healthy class and one of the distress classes. Stable distress was predicted by higher baseline depression and psychiatric history and younger age of onset of Parkinson's disease. Those with younger age of onset were also more likely to become distressed over the course of the study.Conclusions Psychopathology was characterized by relatively stable anxiety or anxious-depression over the 4-year period. Anxiety, with or without depression, appears to be the prominent psychopathological phenotype in Parkinson's disease suggesting a pressing need to understanding its mechanisms and improve management.

Publication metadata

Author(s): Landau S, Harris V, Burn DJ, Hindle JV, Hurt CS, Samuel M, Wilson KC, Brown RG

Publication type: Article

Publication status: Published

Journal: Psychological Medicine

Year: 2016

Volume: 46

Issue: 3

Pages: 657-667

Print publication date: 01/02/2016

Online publication date: 25/10/2015

Acceptance date: 21/09/2015

ISSN (print): 0033-2917

ISSN (electronic): 1469-8978

Publisher: Cambridge University Press


DOI: 10.1017/S0033291715002196


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Funder referenceFunder name
Wales Dementias and Neurodegenerative Diseases Research Network (NEURODEM Cymru)
British Geriatric Society
National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King's College London
Newcastle National Institute for Health Research (NIHR) Biomedical Research Unit in Lewy Body Dementia
NIHR Dementias and Neurodegenerative Diseases Research Network (DeNDRoN)
NIHR Mental Health Research Network (MHRN)
J-0601Parkinson's UK