TY - JOUR
T1 - Demoralization in Parkinson disease
AU - Koo, Brian B.
AU - Chow, Christopher A.
AU - Shah, Divya R.
AU - Khan, Farhan H.
AU - Steinberg, Brittani
AU - Derlein, Danielle
AU - Nalamada, Keerthana
AU - Para, Kiran Sai
AU - Kakade, Vikramjeet M.
AU - Patel, Amar S.
AU - De Figueiredo, John M.
AU - Louis, Elan D.
N1 - Funding Information:
B. Koo, C. Chow, D. Shah, F. Khan, B. Steinberg, D. Derlein, K. Nalamada, K. Para, V. Kakade, A. Patel, and J. de Figueiredo report no disclosures relevant to the manuscript. E. Louis has received research support from the NIH: National Institute of Neurological Disorders and Stroke (NINDS) No. R01 NS094607 (principal investigator), NINDS No. R01 NS085136 (principal investigator), NINDS No. R01 NS073872 (principal investigator), NINDS No. R01 NS085136 (principal investigator), and NINDS No. R01 NS088257 (principal investigator). He has also received support from the Claire O’Neil Essential Tremor Research Fund (Yale University). Go to Neurology.org/N for full disclosures.
Funding Information:
This study was funded by the NIH and the Claire O’Neil Essential Tremor Research Fund. The authors report no competing interests. Go to Neurology.org/N for full disclosures.
Publisher Copyright:
© 2018 American Academy of Neurology
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Objective To determine the prevalence and associated features of demoralization in Parkinson disease (PD). Methods Participants with PD and controls were prospectively recruited from outpatient movement disorder clinics and the community. Demoralization was defined as scoring positively on the Diagnostic Criteria for Psychosomatic Research, Demoralization questionnaire or Kissane Demoralization Scale score ≥24. Depression was defined as Patient Health Questionnaire-9 score ≥10. Forward stepwise logistic regression was used to determine the odds of having demoralization in the overall, control, and PD cohorts. Results Demoralization occurred in 18.1% of 94 participants with PD and 8.1% of 86 control participants (p = 0.05). These 2 groups were otherwise comparable in age, sex, education, economics, race, and marital status. Although demoralization was highly associated with depression, there were individuals with one and not the other. Among participants with PD, 7 of 19 (36.8%) depressed individuals were not demoralized, and 5 of 17 (29.4%) demoralized individuals were not depressed. In the overall cohort, having PD (odds ratio 2.60, 95% confidence interval 1.00-6.80, p = 0.051) was associated with demoralization, along with younger age and not currently being married. In the PD cohort, younger age and Unified Parkinson's Disease Rating Scale, part III score (per score 1) were associated with demoralization (odds ratio 1.06, 95% confidence interval 1.01-1.12, p = 0.02). Conclusions Demoralization is common in PD and is associated with motor dysfunction. In demoralization, there is a prominent inability to cope, making it somewhat distinct from depression. Treatment approaches are also different, making it important to identify demoralization in patients with PD.
AB - Objective To determine the prevalence and associated features of demoralization in Parkinson disease (PD). Methods Participants with PD and controls were prospectively recruited from outpatient movement disorder clinics and the community. Demoralization was defined as scoring positively on the Diagnostic Criteria for Psychosomatic Research, Demoralization questionnaire or Kissane Demoralization Scale score ≥24. Depression was defined as Patient Health Questionnaire-9 score ≥10. Forward stepwise logistic regression was used to determine the odds of having demoralization in the overall, control, and PD cohorts. Results Demoralization occurred in 18.1% of 94 participants with PD and 8.1% of 86 control participants (p = 0.05). These 2 groups were otherwise comparable in age, sex, education, economics, race, and marital status. Although demoralization was highly associated with depression, there were individuals with one and not the other. Among participants with PD, 7 of 19 (36.8%) depressed individuals were not demoralized, and 5 of 17 (29.4%) demoralized individuals were not depressed. In the overall cohort, having PD (odds ratio 2.60, 95% confidence interval 1.00-6.80, p = 0.051) was associated with demoralization, along with younger age and not currently being married. In the PD cohort, younger age and Unified Parkinson's Disease Rating Scale, part III score (per score 1) were associated with demoralization (odds ratio 1.06, 95% confidence interval 1.01-1.12, p = 0.02). Conclusions Demoralization is common in PD and is associated with motor dysfunction. In demoralization, there is a prominent inability to cope, making it somewhat distinct from depression. Treatment approaches are also different, making it important to identify demoralization in patients with PD.
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U2 - 10.1212/WNL.0000000000005425
DO - 10.1212/WNL.0000000000005425
M3 - Article
C2 - 30478073
AN - SCOPUS:85054936871
SN - 0028-3878
VL - 90
SP - E1613-E1617
JO - Neurology
JF - Neurology
IS - 18
ER -