Prevalence of anxiety in Parkinson's disease: A systematic review and meta-analysis

Abstract

Objective: Prevalence rates of anxiety disorders in Parkinson's disease (PD) vary widely, ranging from 6% up to 55%. The aim of this systematic review was to calculate the average point prevalence of anxiety disorders and clinically relevant anxiety symptoms in PD.

Methods: Using PubMed, we carried out a systematic literature search for studies reporting Diagnostic and Statistical Manual-defined anxiety disorders or clinically relevant anxiety symptoms assessed by an anxiety rating scale.

Results: A total of 49 articles were included and assessed for quality, and 45 articles fulfilled the quality criteria. The average point prevalence of anxiety disorders in PD was 31%, with nonepisodic anxiety being more prevalent than episodic anxiety. Generalized anxiety disorder was the most frequent in 14%, followed by social phobia (13.8%), anxiety not otherwise specified (13.3%), and specific phobia (13.0%). Panic disorder with or without phobia was present in 6.8% of PD patients. Of the patients, 31% fulfilled the criteria for current multiple anxiety disorders. Based on anxiety rating scale cutoff scores, clinically significant anxiety symptoms were present in a weighted average of 25.7%.

Conclusion: This systematic review confirms that anxiety, although often unrecognized, is very common and highlights the need for efficient identification of anxiety in PD. © 2016 International Parkinson and Movement Disorder Society.

Keywords: Anxiety disorders; Parkinson's disease; meta-analysis; review.