Equal Distress and Less Hope in Parkinson's Disease Patients Compared to Brain Tumors Patients

Abstract

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This study examined the psychosocial needs of patients with Parkinson's disease (PwPD) in comparison to patients with brain tumors (PwBT), given the absence of any comparable psychosocial support for PwPD, despite the high demand for psychosocial care.1 On the basis of two previously characterized cohorts, statistical analyses were conducted utilizing the Patient Health Questionnaire‐2 (PHQ‐2), the Generalized Anxiety Disorder‐2 (GAD‐2), the Distress Thermometer (DT) and the Herth Hope Index (HHI). For method details, see Supplemental File S1. The univariate analysis results are in Table 1. Multivariate analysis showed a significant difference between PwPD and PwBT in the sum scores of the PHQ‐2, GAD‐2, DT, and HHI (one‐way MANOVA, F(4, 161) = 19.39, P < 0.001, partial η^2^ = 0.325, Wilk's Λ = 0.675). Post‐hoc analyses (univariate ANOVAs) indicate that PwBT are more likely to be depressed (PHQ‐2, F(1, 164) = 4.764, P = 0.030, partial η^2^ = 0.028) and anxious (GAD‐2, F(1, 164) = 4.546 P < 0.001, partial η^2^ = 0.027), whereas PwPD show comparably high distress levels (DT, F(1, 166) = 0.033, P = 0.856, partial η^2^ = 0.000) and experience less hope (HHI, F(1, 164) = 36.873, P < 0.001, partial η^2^ = 0.184). The ANOVA effect size of the HHI total score was large (η^2^ = 0.184), whereas the effect sizes for the PHQ‐2 and GAD‐2 total scores were small (η^2^ = 0.028 and η^2^ = 0.027, respectively). Showing similar distress and less hope levels, these findings indicate that psychosocial screening should be provided to PwPD to the same extent as to PwBT. The Distress Thermometer could be an effective tool for this purpose.2, 3 Moreover, PwPD showed a medium correlation between the HHI and PHQ‐2 scores (r = −0.496; P < 0.001), GAD‐2 score (r = −0.317; P = 0.001), and DT score (r = −0.315; P = 0.001), as well as a small correlation with physical problems (r = −0.244; P = 0.014) and emotional problems (r = −0.213; P = 0.031). PwBT showed a strong correlation between the HHI and PHQ‐2 scores (r = −0.496; P < 0.001), and a medium correlation with the GAD‐2 score (r = −0.496; P < 0.001) and DT score (r = −0.496; P < 0.001). Hope negatively correlated with anxiety, depression, and distress in both groups. In PwPD, hope also weakly correlated with physical and emotional problems, suggesting that motor and non‐motor symptoms may reduce hope. Conversely, effective treatment for both motor and non‐motor symptoms could improve hope. One limitation of this study is that the majority of patients in both groups had mild disease severity (PwPD H & Y stages I/II = 56.2%; PwBT WHO stages I/II = 65.2%). A study population with more severely affected patients may yield different results on anxiety and depression. For limitations details, see Supplemental File S2. In conclusion, these findings strongly recommend integrating an structured screening and clinical treatment pathway for psychosocial problems into routine clinical practice for PwPD, mirroring the approach used for PwBT.4, 5

Author Roles

(1) Research project: A. Conception, B. Organization, C. Execution; (2) Statistical Analysis: A. Design, B. Execution, C. Review and Critique; (3) Manuscript Preparation: A. Writing of the first draft, B. Review and Critique;

S.D.S.: 1A, 1B, 1C, 2A, 2B, 2C, 3A, 3B

E.T.: 1B, 1C, 2B

M.S.: 1A, 1B, 1C

S.Z.: 1B

M.T.: 1A, 1B, 3B

B.F.: 1A, 2B, 3B

Editing and approval of manuscript: All authors.

Disclosures

Ethical Compliance Statement: All patients gave written informed consent to participate in this study. The study was approved by the ethics committee at Technische Universität Dresden (IRB00001473, EK 37012019) and by the ethics committee at University Hospital Tübingen (reference number 602/2014BO2) and conducted in accordance with relevant guidelines and regulations. We confirm that all authors have read the Journal's position on issues involved in ethical publication and affirm that this work is consistent with those guidelines.

Funding Sources and Conflict of Interest: The authors declare that there are no funding sources or conflicts of interest relevant to this work.

Financial Disclosures for the previous 12 months: The authors declare that there are no additional disclosures to report.

Supporting information

File S1. Methods.

File S2. Limitations.