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Autonomic Failure, Depression and Anxiety in Parkinson's Disease

Published online by Cambridge University Press:  02 January 2018

G. E. Berrios ,
C. Campbell  and
B. E. Politynska
G. E. Berrios*
Affiliation:
Department of Psychiatry, University of Cambridge
C. Campbell
Affiliation:
The Central Hospital, Hatton, Warwick
B. E. Politynska
Affiliation:
Department of Psychiatry, University of Cambridge
*
Dr G. E. Berrios, Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital (Box 189), Hills Road, Cambridge
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Extract

Background

The study tested the hypothesis that subjects with Parkinson's disease (PD) have more autonomic complaints and more attenuation of autonomic reflexes than controls, and that both clusters of variables are related to the presence of anxiety and depression.

Method

Thirty-two subjects and 32 healthy controls matched by age and sex were prospectively compared on psychiatric, cognitive and autonomic tests.

Results

‘Autonomic’ symptoms: were more frequent in PD patients than in healthy controls; were not related to age or changes in autonomic reflexes; were significantly associated with depression and anxiety (medication was not relevant to the association); and did not correlate with motor symptoms.

Conclusions

The diagnosis of anxiety and depression in some PD subjects is likely to be a behavioural phenocopy caused by autonomic failure. This explains why antidepressant medication is often unhelpful in PD subjects diagnosed as depressed.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 6 , June 1995 , pp. 789 - 792
Copyright
Copyright © Royal College of Psychiatrists, 1995 

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References

Baldwa, V. S. & Ewing, D. J. (1977) Heart rate response to Valsalva manoeuvre. Reproducibility in normals, and relation to variation in resting heart rate in diabetics. British Heart Journal, 39, 641–644.Google Scholar
Berrios, G. E. & Samuel, B. (1987) Affective disorder in the neurological patient. Journal of Nervous and Mental Disease, 175, 173–176.Google Scholar
Canter, G. J., de la Torre, R. & Mier, M. (1961) A method for evaluating disability in patients with Parkinson's disease. Journal of Nervous and Mental Disease, 133, 143–147.Google Scholar
Cummings, J. (1992) Depression in Parkinson's disease: a review. American Journal of Psychiatry, 149, 443–454.Google Scholar
Goetz, C. G., Lutge, W. & Tanner, C. M. (1986) Autonomic dysfunction in Parkinson's disease. Neurology, 36, 73–75.CrossRefGoogle ScholarPubMed
Hilsted, J. (1983) Autonomic neuropathy: the diagnosis. Acta Neurologica Scandinavica, 67, 193–201.Google Scholar
Hilsted, J. & Jensen, S. B. (1979) A simple test for autonomic neuropathy in juvenile diabetics. Acta Medica Scandinavica, 205, 385–387.Google Scholar
Hoehn, M. M. & Yahr, M. D. (1967) Parkinsonism: onset, progression, and mortality. Neurology, 17, 427–442.CrossRefGoogle ScholarPubMed
Hughes, A. J., Daniel, S. E., Kilford, L., et al (1992) Accuracy of clinical diagnosis of idiopathic Parkinson's disease. A clinicopathological study of 100 cases. Journal of Neurology, Neurosurgery and Psychiatry, 55, 181–184.CrossRefGoogle ScholarPubMed
Lancet (1992) Parkinson's disease: one illness or many syndromes? Lancet, 339, 1263–1264.Google Scholar
Morel, B. A. (1866) Du délire Émotif. Névrose du système nerveux ganglionaire viscéral. Archives Générales de Médicine, 7, 385–402; 530–551; 700–707.Google Scholar
Oppenheimer, D. (1988) Neuropathology of autonomic failure. In Autonomic Failure (2nd edn) (ed. R. Bannister), pp. 451–463. Oxford: Oxford University Press.Google Scholar
Pearson, J. (1979) Familial dysautonomia (a brief review). Journal of the Autonomic Nervous System, 1, 119–126.Google Scholar
Starkstein, S. E., Preziosi, T. J., Forrester, A. W., et al (1990) Specificity of affective and autonomic symptoms of depression in Parkinson's disease. Journal of Neurology, Neurosurgery and Psychiatry, 53, 869–873.Google Scholar
Wieling, W. (1988) Standing, orthostatic stress, and autonomic function. In Autonomic Failure (2nd edn) (ed. R. Bannister), pp. 308–320. Oxford: Oxford University Press.Google Scholar
Vasquez, A., Jimenez-Jimenez, F. J., Garcia-Ruiz, P., et al (1993) ‘Panic attacks$’ in Parkinson's disease. Acta Neurologica Scandinavica, 87, 14–18.Google Scholar
Zetusky, W. J., Jankovic, J. & Pirozzola, F. J. (1985) The heterogeneity of Parkinson's disease: clinical and prognostic implications. Neurology, 35, 522–526.Google Scholar
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