Objective: To explore the association between gastrointestinal dysfunction and psychological health in Parkinson’s disease (PD) patients.

Background: Parkinson’s disease (PD) is a multisystem disorder in which non-motor symptoms contribute significantly to overall disease burden. Among these, gastrointestinal (GI) dysfunction and psychological distress are both prevalent but are often studied independently. This study examined the association between GI dysfunction and psychological health in individuals with PD, with particular attention to potentially modifiable psychological factors.

Method: Participants (n=113) ages 72±8, 43% female, with an average MDS-UPDRS total score of 61±20, average MDS-UPDRS III score of 36±11, and an average of 6±5 years since diagnosis, completed validated self-report measures of GI dysfunction (GIDS-PD), mood disturbance (POMS), depressive symptoms (CES-D), perceived stress (PSS-10), and social support (ISEL). Correlation, linear regression, and odds ratios examined the association between GI dysfunction and psychological health.

Results: Greater GI symptom burden was significantly associated with higher stress, depressive symptoms, and mood disturbance (r=.2-.3, p<.05). Comparing psychological variables and psychological variables plus confounding variables via linear regression modeling showed that psychological variables accounted for 11-16% unique variance. Mood disturbance and presence of REM Sleep Behavior Disorder were significantly associated with bowel irritability, upper GI, and total GI dysfunction (p<.05). Significantly greater unadjusted odds of constipation were observed in the top quartiles of depressive symptoms (OR 2.8) and mood disturbance (OR 3.0) and perceived stress (OR 6.2) compared to bottom 75%.

Conclusion: This study found a significant relationship between GI dysfunction and psychological health in PD patients. Although PD is fundamentally neurodegenerative, these findings suggest that a meaningful portion of disease-related variability may be associated with psychological health. The gut-brain axis provides a biological framework through which PD patients can implement responsive interventions to manage symptoms. Creating interventions to improve psychological well-being may have the potential to decrease GI discomfort, thereby improving quality of life and fostering agency over PD-related symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-association-between-gastrointestinal-dysfunction-and-psychological-health-in-individuals-with-parkinsons-disease/