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Prevalence of anxiety disorders and anxiety subtypes in patients with Parkinson's disease

Authors

  • Gregory M. Pontone MD,

    1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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  • James R. Williams MHS,

    1. Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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  • Karen E. Anderson MD,

    1. Department of Psychiatry, University of Maryland Medical Center, Baltimore, Maryland, USA
    2. Department of Neurology, University of Maryland Medical Center, Baltimore, Maryland, USA
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  • Gary Chase PhD,

    1. Department of Health Evaluation Science, Pennsylvania State University, Hershey, Pennsylvania, USA
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  • Susanne A. Goldstein MD,

    1. Parkinson's and Movement Disorders Center of Maryland, Elkridge, Maryland, USA
    2. Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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  • Stephen Grill MD, PhD,

    1. Parkinson's and Movement Disorders Center of Maryland, Elkridge, Maryland, USA
    2. Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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  • Elaina S. Hirsch BS,

    1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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  • Susan Lehmann MD,

    1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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  • John T. Little MD,

    1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    2. Department of Psychiatry, Georgetown University School of Medicine, Washington, District of Columbia, USA
    3. Department of Neurology, Georgetown University School of Medicine, Washington, District of Columbia, USA
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  • Russell L. Margolis MD,

    1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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  • Peter V. Rabins MD,

    1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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  • Howard D. Weiss MD,

    1. Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    2. Department of Neurology, Sinai Hospital, Baltimore, Maryland, USA
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  • Laura Marsh MD

    Corresponding author
    1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    2. Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    • Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 300, Baltimore, MD 21287
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  • Potential conflict of interest: None reported.

Abstract

Anxiety disorders are common in Parkinson's disease (PD), but are not well characterized. This study determined the prevalence and clinical correlates of all DSM-IV-TR anxiety disorder diagnoses in a sample of 127 subjects with idiopathic PD who underwent comprehensive assessments administered by a psychiatrist and neurologist. A panel of six psychiatrists with expertise in geriatric psychiatry and/or movement disorders established by consensus all psychiatric diagnoses. Current and lifetime prevalence of at least one anxiety disorder diagnosis was 43% (n = 55) and 49% (n = 63), respectively. Anxiety disorder not otherwise specified, a DSM diagnosis used for anxiety disturbances not meeting criteria for defined subtypes, was the most common diagnosis (30% lifetime prevalence, n = 38). Compared with nonanxious subjects, panic disorder (n = 13) was associated with earlier age of PD onset [50.3 (12.2) vs. 61.0 (13.7) years, P < 0.01], higher rates of motor fluctuations [77% (10/13) vs. 39% (25/64), P = 0.01] and morning dystonia [38% (5/13) vs. 13% (8/62), P < 0.03]. This high prevalence of anxiety disorders, including disturbances often not meeting conventional diagnostic criteria, suggests that anxiety in PD is likely underdiagnosed and undertreated and refined characterization of anxiety disorders in PD is needed. In addition, certain anxiety subtypes may be clinically useful markers associated with disease impact in PD. © 2009 Movement Disorder Society

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