Objective: 1. To develop an inventory to assess Parkinson’s disease (PD) specific anxiety for person centred psychotherapy interventions.
2. To develop manualised cognitive behaviour therapy (CBT) including technology for successful treatment of anxiety in patients with Parkinson’s disease (PWP).
Background: Anxiety, a top rated unmet treatment need in PWP, exacerbates motor symptoms, lowers quality of life, and complicates clinical management.[1]
Method: Non-demented PWP completed a new inventory, PD-specific Anxiety Inventory (PDSAI), to evaluate symptoms of anxiety from 5 domains (disease related, motor, non-motor, cognitive impairment, and complications of therapy), and participated in tailored CBT.
Results: 40% PWP (29/72) met DSM-5 criteria for anxiety disorders. The PDSAI scores were significantly higher in the anxiety disorder group (mean PDSAI=17.34; SD=7.74) vs. PWP without anxiety group (mean PDSAI=7.56, SD=6.84, t=-5.65, p<0.001). Preliminary analysis of the PDSAI demonstrated high internal consistency (chronbach’s alpha= 0.90, split half correlation= 0.72), and high concurrent validity against the Parkinson’s Anxiety Scale (PAS) (rs=0.70, p<0.001).
CBT 1 waitlist controlled RCT with 6-weekly sessions [2] (ACTRN12616000764437) included 20 PWP (9 intervention and 11 control; 35% attrition). Post- compared to pre-intervention showed a significant reduction in the (i) PAS scores [M post= 15.25, SD = 5.15; M pre = 11.65, SD = 4.65; paired t(19) = -2.99, p = .008, d = -0.67, RCI= 45% clinical significant improvement], (ii) PAS B- episodic anxiety [M post= 2.25, SD = 2.29; M pre= 3.25, SD = 2.31; t(19) = -2.44, p = .025, d = -0.55], and (iii) PDSAI scores [M post = 11.95, SD = 7.29, Mdn = 11; M pre= 15.65, SD = 7.37, Mdn = 15; Z = -1.98, p = .048, r = -0.31]. CBT 2 RCT including virtual reality technology [3] (8-weekly sessions) is currently underway with 11 PWP randomised to CBT-VR vs control, to date (ACTRN12618001508268).
Conclusion:
The PDSAI may improve evaluation and selection of anxious PWP for successful anxiety treatment using CBT.
References: [1] Pontone, Dissanayaka et. al. Nature PJ Parkinson’s disease (2019). Report from a multidisciplinary meeting on anxiety as a non-motor manifestation in PD. [2] Dissanayaka et. al. Clinical Gerontologist (2017). Cognitive behaviour therapy for anxiety in PD. [3] Thangavelu, Dissanayaka et. al. Clinical Gerontologist (2020). Designing virtual reality assisted psychotherapy for PD.
To cite this abstract in AMA style:
N. Dissanayaka, G. Byrne, L. Mitchell, J. O'Sullivan, A. Padmassini, E. White, J. Yang, E. Forbes, K. Thangavelu, T. Au, A. Lehn, R. Adam, N. Pachana. Improving Diagnosis and Treatment of Anxiety in Parkinson’s Disease: IDATA-PD Study Update [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/improving-diagnosis-and-treatment-of-anxiety-in-parkinsons-disease-idata-pd-study-update/. Accessed May 9, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/improving-diagnosis-and-treatment-of-anxiety-in-parkinsons-disease-idata-pd-study-update/