Modeling anxiety in Parkinson's disease

Martijn P. G. Broen*, Sebastian Köhler, Anja J. H. Moonen, Mark L. Kuijf, Kathy Dujardin, Laura Marsh, Irene H. Richard, Sergio E. Starkstein, Pablo Martinez-Martin, Albert F. G. Leentjens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background The aim of this work was to construct a model for anxiety in PD and compare the relative contributions of PD-specific and -nonspecific general population risk factors for anxiety in this model. MethodsStructural equation modeling of associations of risk factors with the anxiety outcome using a cross-sectional data set of 342 patients with PD were used. ResultsA model with acceptable to good fit was generated that explained 65% of the variance in anxiety scores. A previous history of depression and the severity of the depressive symptoms scored on the Hamilton Depression Rating Scale were the only nonspecific variables with a direct effect on anxiety. The presence of motor fluctuations and disease-related decline in activities of daily living were PD-specific markers of anxiety. Nonspecific risk factors had a greater influence in the model than PD-specific risk factors. Standardized regression coefficients suggested that the Hamilton Depression Rating Scale score was the most important contributor to the variation in anxiety. A post-hoc analysis showed that the effects of the following variables on anxiety levels were fully mediated by depression: sex; family history of depression; previous history of anxiety; cognitive status; difficulties in non-disease-specific activities of daily living; and severity of motor signs. ConclusionIn this cross-sectional study, we showed that nonspecific general population risk factors are more important markers for anxiety than PD-specific risk factors. Depression was the most prominent marker. PD-specific markers for anxiety appear to be more situational and related to off periods and disease-specific disturbances of activities of daily living.
Original languageEnglish
Pages (from-to)310-316
JournalMovement Disorders
Issue number3
Publication statusPublished - Mar 2016


  • Parkinson's disease
  • anxiety
  • depression
  • model
  • risk factor

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