Highlights
- •What is the primary question addressed by this study?A systematic review was conducted to better define and describe the clinical presentation of atypical anxiety in Parkinson's disease in order to help improve recognition, advance therapeutic development and ultimately optimize routine PD care.
- •What is the main finding of this study?Across the 60 studies meeting inclusion criteria, estimates of atypical anxiety ranged from 15%–51%. We identified a diverse array of anxiety symptoms related to motor and non-motor symptoms of PD, to complications of PD medications (such as “on” and “off” fluctuations), and, to a lesser extent, to cognitive symptoms.
- •What is the meaning of the finding?Atypical anxiety is highly prevalent, clinically relevant, heterogeneous in nature, and a key target for intervention in multidisciplinary PD care.
Abstract
Objective
Anxiety is a prominent concern in Parkinson's disease (PD) that negatively impacts
quality of life, increases functional disability, and complicates clinical management.
Atypical presentations of anxiety are under-recognized and inadequately treated in
patients with PD, compromising global PD care.
Methods
This systematic review focuses on the prevalence, symptomology and clinical correlates
of atypical presentations of PD-related anxiety following PRISMA guidelines.
Results
Of the 60 studies meeting inclusion criteria, 14 focused on 'Anxiety Not Otherwise
Specified (NOS)’ or equivalent, 31 reported on fluctuating anxiety symptoms, and 22
reported on 'Fear of Falling (FOF)'. Anxiety NOS accounted for a weighted mean prevalence
of 14.9%, fluctuating anxiety for 34.19%, and FOF for 51.5%. These latter two exceeded
the average reported overall prevalence rate of 31% for anxiety disorders in PD. We
identified a diverse array of anxiety symptoms related to motor and non-motor symptoms
of PD, to complications of PD medication (such as “on” and “off” fluctuations, or
both), and, to a lesser extent, to cognitive symptoms.
Conclusion
Atypical anxiety is common, clinically relevant, and heterogeneous in nature. A better
understanding of the phenomenology, clinical course, and pathophysiology of varied
forms of atypical anxiety in PD is needed to improve recognition, advance therapeutic
development and ultimately optimize quality of life in PD.
Key Words
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Article info
Publication history
Published online: February 15, 2022
Accepted:
February 10,
2022
Received in revised form:
February 3,
2022
Received:
November 14,
2021
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.
