Incidence of Anxiety in Parkinson’s Disease During the Coronavirus Disease (COVID-19) Pandemic

28Sep

Incidence of Anxiety in Parkinson's Disease During the Coronavirus Disease (COVID-19) Pandemic

The recent pandemic of coronavirus disease 2019 (COVID‐19) have forced countries to be under lockdown, with strict emphasis being placed on self‐isolation and social distancing. The major impact of this mandate is on patients with chronic diseases. Parkinson’s disease (PD) is a chronic neurodegenerative disease, and anxiety is one of the most frequent neuropsychiatric disorders in PD, with an incidence higher than in any other chronic medical diseases (38% vs. 11%). The recent outbreak of coronavirus could be a contributing factor for worsening anxiety in this group of individuals.

Various studies all over the globe from Iran to US has looked into the effect of COVID-19 on Patients with Parkinson’s Disease.

Changes in behaviour were reported by 73 patients (99% performed at least one specific preventive behavior, and 86.9% have reduced social contacts and stayed home). A closer analysis of qualitative answers showed that 27.3% of patients continued to meet relatives face-to-face almost daily. Anxiety and worries about the current situation were reported by 58.6% of patients; 31.3% complained about a decrease in their mobility since the beginning of the restrictions, mainly because of worsening of PD and because regular therapies (e.g., physiotherapy) were cancelled. About 30% of PD patients are nonadherent to preventive measures.(3)

358 PD patients completed the survey between April 21 and May 25, 2020 (response rate 71.9%). Patients with higher COVID-related stressor load experienced more PD symptoms, and this effect was mediated by the degree of psychological distress. 46.6% of PD patients were less physically active since the COVID-19 pandemic, and reduced physical activity correlated with worse PD symptoms. Symptoms that worsened most were rigidity, fatigue, tremor, pain and concentration. Presence of neuropsychiatric symptoms (anxiety, depression) before the pandemic, as well as cognitive dysfunction and several personality traits predicted increased psychological distress during the COVID-19 pandemic. Their findings show how an external stressor (the COVID-19 pandemic) leads to a worsening of PD symptoms by evoking psychological distress as well as lifestyle changes (reduced physical activity).(4)

Although the long‐term impact of the COVID‐19 pandemic on PD patients is yet to be determined, it seems that these patients are more prone to psychological disturbances attributed to the imposition of quarantine measures, social distancing, and fear of getting infected by COVID‐19. These psychological disturbances may be attributed to the worsening of a preexisting anxiety, uncertainty regarding obtaining medications during lockdown, and the perceived higher risk of contracting COVID‐19 because of an underlying chronic medical condition.

  1. Incidence of Anxiety in Parkinson’s Disease During the Coronavirus Disease (COVID-19) Pandemic. Salari M, Zali A, Ashrafi F, Etemadifar M, Sharma S, Hajizadeh N, Ashourizadeh H.Mov Disord. 2020 Jul;35(7):1095-1096. doi: 10.1002/mds.28116. Epub 2020 May 21.
  2. Mental Health, Physical Activity, and Quality of Life in Parkinson’s Disease During COVID-19 Pandemic. Shalash A, Roushdy T, Essam M, Fathy M, Dawood NL, Abushady EM, Elrassas H, Helmi A, Hamid E. Mov Disord. 2020 Jul;35(7):1097-1099. doi: 10.1002/mds.28134. Epub 2020 Jun 7.
  3. Knowledge, Attitudes, Practices, and Burden During the COVID-19 Pandemic in People with Parkinson’s Disease in Germany. Zipprich HM, Teschner U, Witte OW, Schönenberg A, Prell T. J Clin Med. 2020 May 29;9(6):1643. doi: 10.3390/jcm9061643.
  4. The Impact of the COVID-19 Pandemic on Psychological Distress, Physical Activity, and Symptom Severity in Parkinson’s Disease van der Heide A, Meinders MJ, Bloem BR, Helmich RC. J Parkinsons Dis. 2020 Aug 27. doi: 10.3233/JPD-202251. Online ahead of print.
  5. Prevalence and impact of COVID-19 in Parkinson’s disease: evidence from a multi-center survey in Tuscany region. Del Prete E, Francesconi A, Palermo G, Mazzucchi S, et al; Tuscany Parkinson COVID-19 Participants. J Neurol. 2020 Sep 3:1-9. doi: 10.1007/s00415-020-10002-6. Online ahead of print.