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THE ASSOCIATION OF ANXIETY AND DEPRESSION WITH TREMORS IN PARKINSON’S DISEASE PATIENTS

F. Susanti, C. Arina, H. Hutagalung (Medan, Indonesia)

Meeting: MDS Virtual Congress 2021

Abstract Number: 998

Keywords: Anxiety, Depression, Resting tremors

Category: Parkinson's Disease: Non-Motor Symptoms

Objective: To determine the relation between anxiety and depression with tremors in patients with PD so that it can be possible to detect the symptoms as early as possible

Background: Anxiety and depression are non motor symptoms found in Parkinson’s disease (PD) and go undetected because of overlapping motor symptoms while tremor is a typical motor symptom experienced by 75% of patients with PD

Method: This study used a cross- sectional design. The subjects were PD patients at the neurologica polyclinic at Haji Adam Malik Hospital Medan, North Sumatra Hospital and Kesdam Bukit Barisan Hospital during 17 September 2020- 20 December 2020 who met the inclusion criteria. Anxiety assesment used the Hamilton Anxiety Rating Scale (HARS) Questionnaire, depression with the Beck Depression Index (BDI) and tremor used Unified Parkinson’s Disease Rating Scale (UPDRS) III (Specific items for tremors 20-21). The Data was analysed using the Spearman correlation test.

Results: The 28 subjects who met the inclusion criteria, 17 patients were male (60.7%), the mean age of the subjects was 64.96 ± 7.73 years. Most education level is higher education, 9 retirees (32.1%) and 12 Bataknese (42.9%). The most severity level of PD based on H&Y on stage 1 was 11 people (39.3%), the average length of time consuming L-Dopa was 4.84 years (SD = 3.43). The highest level of anxiety and depression is no anxiety and severe 8 persons (28,6%) and no depression 13 Persons (46,4%). There’s a significant relation between HARS and tremor score (r = 0.847; p <0.001) and  BDI and tremor score(r =0.737; p <0.001).

Conclusion: There’s a significant relation between anxiety and depression with tremor in PD patients.  The more anxiety and depression, the more severe the tremors will be.

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References: 1. Ray, S. and Agarwal, P. 2019. Depression and Anxiety in Parkinson Disease. Clin Geriatr Med. 36(1): 93–104. 2. Pontone, G.M., Bakker, C.C., Chen, S., Mari, Z., Marsh, L., Peter, R. et al. 2015. The Longitudal impact of depression on disability in Parkinson disease. International Journal of Geriatric Psychiatry. 3(1): 458-465. 3. Dewati, E., Dyah, T. dan Ariarini, N.N.R. 2017. Penyakit Parkinson. Dalam : Anindhita, T. dan Winnugroho, W. (Ed). Buku Ajar Neurologi Edisi 1 hal 105-135. Departemen Neurologi Fakultas Kedokteran Universitas Indonesia. Jakarta. 4. . Heusinkveld, L.E., Hacker, M.L., Turchan, M., Davis, T.L. and Charles, D. 2018. Impact of Tremor on Patients With Early Stage Parkinson’s Disease. Frontiers in Neurology. 9 (1): 1-5. 5. Simpson, H. 2015. Tremor Management for Parkinson’s Disease and Essential Tremor. https://movementdisorders.ufhealth.org/ /2015/02/12/tremor-management-for-parkinsons-disease-andessential-tremors/ .15 September 2020. 6. Adinda, F., Anwar, Y., dan Hutagalung, S.H. 2020. Hubungan Disfungsi Otonom dengan Kualitas Hidup Pada Pasien Penyakit Parkinson. [Tesis]. North Sumatera: Medical Faculty University of North Sumatera, Specialist Doctor Education Program. 7. Paramitha, P., Fithrie, A., dan Hutagalung, S.H. 2020. Hubungan Antara Tingkat Keparahan dengan Tingkat Depresi Pada Pasien Penyakit Parkinson. [Tesis] North Sumatera: : Medical Faculty University of North Sumatera, Magister of Medicine Education Program. 8. Syamsudin, T. 2015. Penyakit Parkinson. Dalam: Syamsudin, T., Subagya., Akbar, M. (Ed). Buku Panduan Tatalaksana Penyakit Parkinson dan Gangguan Gerak Lainnya hal 9-31. Kelompok Studi Movement Disorder. Perhimpunan Dokter Spesialis Saraf Indonesia. 9. Collier, T.J., Kanaan, N.M., and Kordower, J.H. 2011. Ageing as a Primary Risk Factor for Parkinson’s Disease : Evidence from Studies of Non Human Primates. Nature Reviews. 12(6): 359-366. 10. Meara, J. and Hobson, P. 2018. Epidemiology of Parkinson’s Disease. In: Palyfer, J. and Hindle, J. (Eds). Parkinson’s Disease in the Older Patient 2nd Edition Page 30-38. Taylor and Francis Group. New York. 11. Liu, W.M., Lin, R.J., Yu, R.L., Tai, C.H., Lin, C.H. and Wu, R.M. 2015. The Impact of Nonmotor Symptoms on Quality of Life in Patients With Parkinson’s Disease in Taiwan. Neuropsychiatric Disease and Treatment. 11(2015): 2865-2873. 12. Benton, J.L., Wengel, S.P. and Burke, W.J. 2013. Depression in Parkinson’s Disease: An Update. In: Pfeiffer, R.F and Wollner, B. (Eds). Parkinson’s Disease and Nonmotor Dysfunction Second Edition Page 3-12. Humana Press. Boston. USA. 13. Collier, T.J., Kanaan, N.M., and Kordower, J.H. 2011. Ageing as a Primary Risk Factor for Parkinson’s Disease : Evidence from Studies of Non Human Primates. Nature Reviews. 12(6): 359-366. 14. Elise, G. V., Andel, R., Sieurin,J., Feldman, L.A., Jerri, D.E., Langstrom, N. et al. 2014. Occupational Complexity and Risk of Parkinson’s Disease. Plos One. 9(9) : 1-5. 15. Elise, G. V., Andel, R., Sieurin,J., Feldman, L.A., Jerri, D.E., Langstrom, N. et al. 2014. Occupational Complexity and Risk of Parkinson’s Disease. Plos One. 9(9) : 1-5. 16. Frigerio,R., Elbaz, A., Sanft, K.R., Peterson, B.J., Bower, J.H., Ahlskog, J.E. et al. 2005. Education and occupations preceding Parkinson disease. NEUROLOGY. 65(2005): 1575–1583. 17. Haaxma, C. A., Bloem, B.R., Borm, G.F., Oyen, W.J.G., Leenders, K.L., Eshuis, S., et al. 2007. Gender Differences in Parkinson’s Disease. J Neurol Neurosurg Psychiatry. 78(8): 819-824. 18. Hortes, M., Chagas, N., Helena, T. G., Oliveira, F., Linares, M.P., Balarini, F.B. et al. 2017. Can anxiety increase tremors in patients with Parkinson’s disease? An experimental model. Arch Clin Psychiatry .44(4): 85-88. 19. Ring, H.A. and Mestres, J.S. 2002. Neuropsychiatry of the basal ganglia. J Neurol Neurosurge Psychiatry. 72(1): 12-21. 20. Benton, J.L., Wengel, S.P. and Burke, W.J. 2013. Depression in Parkinson’s Disease: An Update. In: Pfeiffer, R.F and Wollner, B. (Eds). Parkinson’s Disease and Nonmotor Dysfunction Second Edition Page 3-12. Humana Press. Boston. USA.

To cite this abstract in AMA style:

F. Susanti, C. Arina, H. Hutagalung. THE ASSOCIATION OF ANXIETY AND DEPRESSION WITH TREMORS IN PARKINSON’S DISEASE PATIENTS [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/the-association-of-anxiety-and-depression-with-tremors-in-parkinsons-disease-patients/. Accessed June 15, 2025.
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