Objective: To examine the prevalence of clinically significant anxiety symptoms, their overlap with depressive symptoms, and associated pharmacologic treatment patterns in Parkinson’s disease (PD).

Background: Anxiety symptoms are common in PD and frequently co-occur with depressive symptoms, although they may also occur independently. Because anxiety and depression are often treated with similar medications, depressive symptoms may influence the recognition and pharmacologic treatment of anxiety in PD.

Method: A cross-sectional analysis was conducted in 113 individuals with PD enrolled in an observational study at the Pacific Parkinson’s Research Centre in Vancouver, Canada [1]. Participants completed the Parkinson Anxiety Scale (PAS) and the Beck Depression Inventory-IA (BDI-IA). Clinically significant anxiety and depressive symptoms were defined as a PAS total score ≥14 and a BDI-IA score ≥10, respectively. Participants were categorized into four groups: no anxiety or depression, anxiety only, depression only, and both anxiety and depression. Current use of anxiolytic or antidepressant medications was examined across groups.

Results: The PD sample included 72 males and 41 females, with a mean age of 66.4 (SD 7.9) years and mean disease duration of 6.3 (SD 3.1) years. Clinically significant anxiety symptoms were present in 25 (22.1%) participants and depressive symptoms in 32 (28.3%). Symptom group distribution was as follows: no anxiety or depression (n = 71, 62.8%), anxiety only (n = 10, 8.8%), depression only (n = 17, 15.0%), and both anxiety and depression (n = 15, 13.3%). Overall, 33 (29.2%) participants were receiving anxiolytic or antidepressant medications. Treatment rates varied across groups: 18/71 (25.4%) among those with no anxiety or depression, 2/10 (20.0%) with anxiety only, 6/17 (35.3%) with depression only, and 7/15 (46.7%) with both anxiety and depression.

Conclusion: Close to one quarter of individuals with PD in our sample had clinically significant anxiety symptoms. Pharmacologic treatment was more common when anxiety co-occurred with depression, whereas individuals with anxiety alone were less frequently treated. Our findings suggest that anxiety without comorbid depression may be underrecognized and undertreated in clinical practice.

References: [1] Cirstea, M.S., Yu, A.C., Golz, E., Sundvick, K., Kliger, D., Radisavljevic, N., Foulger, L.H., Mackenzie, M., Huan, T., Finlay, B.B. and Appel-Cresswell, S. (2020), Microbiota composition and metabolism are associated with gut function in Parkinson’s disease. Mov Disord, 35: 1208-1217.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-and-treatment-patterns-of-anxiety-symptoms-in-parkinsons-disease/