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Zhao Y, Wu W, Wu J, Shen B, Cao Y, Xu Y. Risk factors and intervention of caregiver burden in Parkinson's disease: a systematic review and meta-analysis. Qual Life Res 2024; 33:1753-1766. [PMID: 38573387 DOI: 10.1007/s11136-024-03616-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE This study summarized characteristics and risk factors of caregiver burden in PD patients and used meta-analysis to verify the effectiveness of the intervention on caregiver burden. METHODS Systematic review and meta-analysis were conducted. RESULTS Forty-nine articles that involved 5387 caregivers of patients with PD were included in this study. Results of systematic review indicated that Zarit burden Inventory (ZBI) was the most used scale to measure the caregiver burden. All scales revealed caregivers of PD patients had mild to moderate caregiver burden. For the PD patients with longer disease duration, severer disease severity, more negative emotion and cognition impairment, their caregivers intended to have higher caregiver burden. The caregiver with negative emotion and who spent more time on caregiving indicated higher caregiver burden than the others. The caregiver burden was not improved after deep brain stimulation (DBS). Meta-analysis showed that cognitive behavior therapy and palliative care had no significant effect to reduce caregiver burden in PD patients' caregiver. CONCLUSION Caregivers of PD patients experienced mild to moderate caregiver burden. Demographic factor, diseased-related factor and negative emotional factor were the risk factors of caregiver burden. Health education and care support for long-term management after DBS surgery should be provided for patients and caregivers to decrease caregiver burden.
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Affiliation(s)
- Yan Zhao
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Wenxiang Wu
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Jianjun Wu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Bin Shen
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Yanpei Cao
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China.
| | - Yafang Xu
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China.
- National Center for Neurological Disorders, Shanghai, China.
- Huashan Rare Disease Center, Huashan Hospital, Fudan University, Shanghai, China.
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van Munster M, Pedrosa AJ, Künkler C, Pedrosa DJ. The Quality in Quality of Life in Parkinson's Disease: A Qualitative Meta-Synthesis. Mov Disord Clin Pract 2024; 11:761-769. [PMID: 38715240 PMCID: PMC11233873 DOI: 10.1002/mdc3.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/29/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Quality of life (QoL) is known to be impaired in people with Parkinson's disease (PwPD). Not surprisingly, a considerable effort of health interventions is aimed at maintaining or improving QoL. Yet, little is known about its determinants from a PwPD perspective to inform person-centered health care interventions. OBJECTIVES This systematic review aims to overcome this information gap by synthesizing existing evidence on factors associated with PwPD' self-perceived QoL. METHODS We searched six electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, Cochrane Library) from inception to January 2022 for eligible qualitative studies of QoL in PwPD, supplemented by citation tracking and hand searching. Study quality was assessed using the QualSyst tool. In order to characterize the determinants of QoL in PwPD, we conducted a qualitative meta-synthesis. RESULTS Our analysis revealed a wide range of facilitators and barriers to QoL relating to seven overarching themes: Illness experience, health care, everyday life, social life, identity, spirituality/religion, and environment. CONCLUSIONS Our systematic review reinforces the impact of symptom experience on PwPD's QoL. However, it also highlights the need to consider the non-physical dimensions of PD when assessing patients' QoL. It is therefore essential that health care professionals acknowledge the psychological, social and spiritual repercussions of PD and endeavor to respond to these concerns through a comprehensive and patient-centered strategy. Further research is needed to gain a deeper understanding of these facets of PD and to formulate successful interventions aimed at improving the QoL of PwPD.
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Affiliation(s)
- Marlena van Munster
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
- Department of International Health, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Anna J Pedrosa
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
| | - Carolin Künkler
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
| | - David J Pedrosa
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
- Centre for Mind, Brain and Behavior, Philipps-University Marburg, Marburg, Germany
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Kaplan RI, McDowell CP, Wall J, Kinger SB, Salazar RD, Neargarder S, Cronin‐Golomb A. Discordance between Reports of Internalized Symptoms in Persons with Parkinson's Disease and Informants: Results from an Online Survey. Mov Disord Clin Pract 2024; 11:391-397. [PMID: 38269854 PMCID: PMC10982598 DOI: 10.1002/mdc3.13971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/19/2023] [Accepted: 12/13/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Self-report of motor and non-motor symptoms is integral to understanding daily challenges of persons with Parkinson's disease (PwPD). Care partners are often asked to serve as informants regarding symptom severity, raising the question of concordance with PwPD self-reports, especially regarding internalized (not outwardly visible) symptoms. OBJECTIVES Concordance between PwPD and informant ratings of motor and non-motor symptoms was evaluated across multiple domains. METHODS In 60 PwPD-informant pairs, we compared ratings on 11 online self-report measures comprising 33 total scores, 2/3 of which represented purely internalized symptoms. For discordant scores, multiple regression analyses were used to examine demographic/clinical predictors. RESULTS Though concordant on 85% of measures, PwPD endorsed more non-motor symptoms, bodily discomfort, stigma, and motor symptoms than informants. For PwPD, younger age, greater disease severity, and female gender predicted discordance. CONCLUSIONS Discordance between PwPD and informants on measures assessing symptoms that cannot be outwardly observed may require targeted education.
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Affiliation(s)
- Rini I. Kaplan
- Department of Psychological and Brain SciencesBoston UniversityBostonMAUSA
| | | | - Juliana Wall
- Department of Psychological and Brain SciencesBoston UniversityBostonMAUSA
| | - Shraddha B. Kinger
- Department of Psychological and Brain SciencesBoston UniversityBostonMAUSA
| | - Robert D. Salazar
- Department of Psychological and Brain SciencesBoston UniversityBostonMAUSA
| | - Sandy Neargarder
- Department of Psychological and Brain SciencesBoston UniversityBostonMAUSA
- Department of PsychologyBridgewater State UniversityBridgewaterMAUSA
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Aamodt WW, Kluger BM, Mirham M, Job A, Lettenberger SE, Mosley PE, Seshadri S. Caregiver Burden in Parkinson Disease: A Scoping Review of the Literature from 2017-2022. J Geriatr Psychiatry Neurol 2024; 37:96-113. [PMID: 37551798 PMCID: PMC10802092 DOI: 10.1177/08919887231195219] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Caregiver burden is a term that refers to the adverse effect of caregiving on the physical, emotional, social, spiritual, and financial well-being of the caregiver. Caregiver burden is associated with providing care to an individual with a chronic illness or disability, and the unique symptoms of Parkinson disease (PD) can amplify a patient's needs and reliance on others, leading to adverse outcomes for patients and their caregivers. In this scoping review of the literature from January 2017 through April 2022 that included 114 studies, we provide an updated, evidence-based summary of patient and caregiver-related factors that contribute to caregiver burden in PD. We also describe the impact of caregiver stress and burden on caregivers based on qualitative research studies and review recent interventions to mitigate burden. By providing clinical updates for practitioners, this review is designed to improve recognition of caregiver burden in the post-pandemic era and foster the development of targeted interventions to reduce caregiver burden in PD.
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Affiliation(s)
- Whitley W. Aamodt
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
- Translational Center of Excellence for Neuroepidemiology and Neurology Outcomes Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Benzi M. Kluger
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Miray Mirham
- School of Medicine, University of Rochester, Rochester, NY, USA
| | - Anna Job
- University of Rochester, Rochester, NY, USA
| | | | - Philip E. Mosley
- School of Medicine, University of Queensland, Herston, QLD, Australia
| | - Sandhya Seshadri
- Department of Neurology, University of Rochester, Rochester, NY, USA
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Sidoroff V, Carbone F, Ellmerer P, Bair S, Hoffmann A, Maran T, Krismer F, Mahlknecht P, Mair K, Raccagni C, Ndayisaba JP, Seppi K, Wenning GK, Djamshidian A. Emotion Recognition in Multiple System Atrophy: An Exploratory Eye-Tracking Study. J Mov Disord 2024; 17:38-46. [PMID: 37748924 PMCID: PMC10846972 DOI: 10.14802/jmd.23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/25/2023] [Accepted: 09/24/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Emotional processing is a core feature of social interactions and has been well studied in patients with idiopathic Parkinson's disease (PD), albeit with contradictory. RESULTS . However, these studies excluded patients with atypical parkinsonism, such as multiple system atrophy (MSA). The objective of this exploratory study was to provide better insights into emotion processing in patients with MSA using eye tracking data. METHODS We included 21 MSA patients, 15 PD patients and 19 matched controls in this study. Participants performed a dynamic and a static emotion recognition task, and gaze fixations were analyzed in different areas of interest. Participants underwent neuropsychological testing and assessment of depression and alexithymia. RESULTS MSA patients were less accurate in recognizing anger than controls (p = 0.02) and had overall fewer fixations than controls (p = 0.001). In the static task, MSA patients had fewer fixations (p < 0.001) and a longer time to first fixation (p = 0.026) on the eye region. Furthermore, MSA patients had a longer fixation duration overall than PD patients (p = 0.004) and longer fixations on the nose than controls (p = 0.005). Alexithymia scores were higher in MSA patients compared to controls (p = 0.038). CONCLUSION This study demonstrated impaired recognition of anger in MSA patients compared to HCs. Fewer and later fixations on the eyes along with a center bias suggest avoidance of eye contact, which may be a characteristic gaze behavior in MSA patients.
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Affiliation(s)
- Victoria Sidoroff
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Federico Carbone
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Ellmerer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefanie Bair
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Thomas Maran
- Department of Strategic Management & Leadership, University of Innsbruck, Innsbruck Austria
- Entrepreneurship and Innovation, Free University of Bozen-Bolzano, Bozen-Bolzano, Italy
| | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Mahlknecht
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Katherina Mair
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Cecilia Raccagni
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Neurology, Provincial Hospital of Bolzano Teaching Hospital of Paracelsus Medical Private University Bolzano-Bozen, Bolzano, Italy
| | | | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gregor K. Wenning
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Boudabbous M, Issa AB, Feki I, Gdoura H, Chtourou L, Moalla M, Sallemi R, Mnif L, Amouri A, Masmoudi J, Tahri N. Alexithymia impairs quality of life in irritable bowel syndrome. Future Sci OA 2023; 9:FSO881. [PMID: 37753356 PMCID: PMC10518833 DOI: 10.2144/fsoa-2023-0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/27/2023] [Indexed: 09/28/2023] Open
Abstract
Aim Our objectives were to compare the frequency of alexithymia and the alteration of quality of life in irritable bowel syndrome (IBS) and to determine the factors associated with alexithymia and quality of life deterioration. Method This is a comparative study which collected 80 IBS patients and 80 controls. Results Quality of life was impaired in 75% of patients vs 37.5% (p < 0.0001). The prevalence of alexithymia was 50% in patients vs 1.2% (p < 0.0001). In multivariate analysis, an impaired quality of life was associated with alexithymia (p = 0.003). The factors associated with impaired quality of life were anxiety and alexithymia. Conclusion Alexithymia was present in half of patients with IBS and its was associated with impaired quality of life.
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Affiliation(s)
- Mona Boudabbous
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | | | - Ines Feki
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Héla Gdoura
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Lassad Chtourou
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Manel Moalla
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Rim Sallemi
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - leila Mnif
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Ali Amouri
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Jaweher Masmoudi
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Nabil Tahri
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
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7
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The Relationship among Dyadic Adjustment and Disease Burden in Patients with Bipolar Disorder and Their Spouses. Behav Sci (Basel) 2023; 13:bs13020091. [PMID: 36829320 PMCID: PMC9952473 DOI: 10.3390/bs13020091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
(1) Background: Spouses of individuals with bipolar disorder (BD) experience significant burdens, and the perception of the burden may affect dyadic adjustment. We aimed to investigate the sexual functions, alexithymic traits, marital satisfaction, and burden in patients with BD and their spouses. We also aimed to assess the mediating role of sexual functions and alexithymia in the relationship between burden and dyadic adjustment. (2) Methods: We included 81 patients with BD type 1 (40.69 ± 8.55 years, 65.4% female, and 34.6% male) and their healthy spouses (40.95 ± 7.30 years, 34.6% female, and 65.4% male) and 78 healthy controls (38.90 ± 5.88, 48.7% female, and 51.3% male). The participants were evaluated using the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), Dyadic Adjustment Scale (DAS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20), and Burden Assessment Scale (BAS). (3) Results: The GRISS scores of the control group were significantly lower than the spouses and BD groups. The DAS total score of the control group was significantly higher than that of the spouses and BD groups. Regression analyses revealed that TAS, GRISS, and HDRS scores were associated with DAS scores in the BD group. In the spouse group, TAS and BAS scores were associated with DAS scores. The GRISS scores partially mediated the relationship between dyadic adjustment and burden in the spouses of patients with BD. (4) Conclusions: Mental health professionals should regularly scan caregivers' perceptions of burden. Appropriate psychosocial interventions could help spouses of patients with BD to cope better with the burden and improve dyadic adjustment.
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8
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Höllerhage M, Klietz M, Höglinger GU. Disease modification in Parkinsonism: obstacles and ways forward. J Neural Transm (Vienna) 2022; 129:1133-1153. [PMID: 35695938 PMCID: PMC9463344 DOI: 10.1007/s00702-022-02520-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/21/2022] [Indexed: 12/19/2022]
Abstract
To date, the diagnoses of Parkinson syndromes are based on clinical examination. Therefore, these specific diagnoses are made, when the neuropathological process is already advanced. However, disease modification or neuroprotection, is considered to be most effective before marked neurodegeneration has occurred. In recent years, early clinical or prodromal stages of Parkinson syndromes came into focus. Moreover, subtypes of distinct diseases will allow predictions of the individual course of the diseases more precisely. Thereby, patients will be enrolled into clinical trials with more specific disease entities and endpoints. Furthermore, novel fluid and imaging biomarkers that allow biochemical diagnoses are under development. These will lead to earlier diagnoses and earlier therapy in the future as consequence. Furthermore, therapeutic approaches will take the underlying neuropathological process of neurodegenerative Parkinson syndromes more specific into account. Specifically, future therapies will target the aggregation of aggregation-prone proteins such as alpha-synuclein and tau, the degradation of pathological aggregates, and the spreading of pathological protein aggregates throughout the brain. Many of these approaches are already in (pre)clinical development. In addition, anti-inflammatory approaches are in development. Furthermore, drug-repurposing is a feasible approach to shorten the developmental process of new drugs.
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Affiliation(s)
- M Höllerhage
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - M Klietz
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - G U Höglinger
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Szepietowska M, Dąbrowska A, Nowak B, Skinderowicz K, Wilczyński B, Krajewski PK, Jankowska-Konsur A. Alexithymia in Adolescents with Acne: Association with Quality of Life Impairment and Stigmatization. J Clin Med 2022; 11:732. [PMID: 35160183 PMCID: PMC8837167 DOI: 10.3390/jcm11030732] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 12/10/2022] Open
Abstract
Alexithymia seems to be more common among patients with skin diseases. However, studies on acne patients are very limited. We conducted this study to evaluate alexithymia in adolescents with acne. In our cross-sectional study, 730 high school students (mean age: 17.05 ± 1.18 years) were recruited. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia, the Dermatology Life Quality Index (DLQI) was employed to study quality of life (QoL), and the 6-item Stigmatization Scale (6ISS) was used to evaluate the level of stigmatization in acne subjects. Alexithymia was found in 31% of adolescents, with similar prevalence among those with and without acne (31.3% and 30.1%, respectively). The mean scoring on the TAS-20 in patients with acne (53.1 ± 12.8 points) was not significantly different from that of the non-acne group (53.5 ± 11.9 points). However, significant correlations between TAS-20 scores and QoL assessments (r = 0.332, p < 0.001) as well as stigmatization level (r = 0.284, p < 0.001) were found. These correlations were also significant for the domains of alexithymia described as difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF), but not for externally oriented thinking (EOT). The findings clearly showed that acne does not predispose to alexithymia; however, alexithymia in acne subjects is related to impaired QoL and stigmatization.
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Affiliation(s)
- Marta Szepietowska
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Alicja Dąbrowska
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Bernadetta Nowak
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Katarzyna Skinderowicz
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Bartosz Wilczyński
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Piotr K. Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Alina Jankowska-Konsur
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
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Neuropsychiatric Symptoms in Parkinson’s Disease Patients Are Associated with Reduced Health-Related Quality of Life and Increased Caregiver Burden. Brain Sci 2022; 12:brainsci12010089. [PMID: 35053832 PMCID: PMC8774188 DOI: 10.3390/brainsci12010089] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/29/2021] [Accepted: 01/07/2022] [Indexed: 01/11/2023] Open
Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disorder resulting in reduced health-related quality of life (HR-QoL) of people with PD (PwP) and their caregivers. Furthermore, there is an accumulating burden on caregivers of patients in advanced stages of the disease. In previous studies, motor- and non-motor-symptoms of PwP have been identified to contribute to reduced HR-QoL and an increased caregiver burden. This cross-sectional observational study aimed to study the influence of neuropsychiatric symptoms measured with the Scale for Evaluation of Neuropsychiatric Disorders in Parkinson’s Disease (SEND-PD) questionnaire on the HR-QoL of PwP, as well as the caregiver burden. Analyses revealed a significant association between SEND-PD subscale mood/apathy and reduced HR-QoL in PwP, measured by the Parkinson’s disease quality of life questionnaire (PDQ-8) (p < 0.001). Furthermore, mood/apathy was significantly correlated with caregiver burden (p = 0.001) in the multiple linear regression analysis. Hence, neuropsychiatric symptoms were found to have a profound impact on the HR-QoL of PwP, as well as on caregiver burden. Since neuropsychiatric symptoms were one of the main predictors for caregiver burden, physicians of PwP should treat these symptoms to stabilize caregiver burden, as well as HR-QoL in PwP and their caregivers.
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Analysis of Transition of Patients with Parkinson's Disease into Institutional Care: A Retrospective Pilot Study. Brain Sci 2021; 11:brainsci11111470. [PMID: 34827469 PMCID: PMC8615464 DOI: 10.3390/brainsci11111470] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 01/16/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disease which gives a person a high risk of becoming care-dependent. During disease progression, the amount of care concerning activities of daily living can increase, possibly resulting in transition of the people with Parkinson's disease (PwP) to a care facility. However, there is a lack of knowledge concerning the factors leading to institutionalization of PwP and the consequences for them and their informal caregivers. The aim of this cross-sectional retrospective study was to investigate reasons leading to the transition into an institutional care facility, the process of decision-making and its effects on PwP symptoms and caregiver burden. Participating PwP had to be institutionalized for at most one year after transition at study inclusion. Participants completed a range of semiquantitative questionnaires as well as the caregiving tasks questionnaire. Fourteen patient-caregiver pairs were included. PwP suffered from late-stage PD symptoms with high dependence on help, experiencing several hospitalizations before transition. Analyses revealed a significant decrease in caregiver burden and depressive symptoms of the caregivers after PwP institutionalization. Factors influencing the transition were, e.g., fear of PwP health issues and concerns about caregivers' health. This study presents new insights into the process of institutionalization and its influence on caregiver burden, including aspects for discussions of physicians with PwP and their caregivers for counselling the decision to move to institutional care.
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Suicide probability in psychiatric patients' primary caregivers: The role of care burden, alexithymia and some risk factors. Arch Psychiatr Nurs 2021; 35:457-464. [PMID: 34561059 DOI: 10.1016/j.apnu.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/05/2021] [Accepted: 06/20/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although suicidal ideation seems to be related with both burden of care and alexithymia, there is no study investigating the correlation between these factors and suicide probability in informal caregivers of psychiatric patients in the literature. AIM In this study, it was aimed to determine the suicide probability in psychiatric patients' primary caregivers, and to evaluate the effects of care burden, alexithymia and some risk factors on suicide probability. METHODS This study was conducted with 262 caregivers between February 2019 and December 2019. Data were collected with the Personal Information Form, Suicide Probability Scale, Zarit Burden Interview, Toronto Alexithymia Scale. RESULTS The mean score the caregivers obtained from the Suicide Probability Scale was 79.75 ± 59.29, and 17.9% of them were at risk for suicide. Also, caregivers' suicide probability was related to variables such as caregivers' sex, economic status, presence of any disease, duration of care, and patients' education level, psychiatric diagnosis, duration of illness, presence of physical illness, compliance with treatment. In addition, caregivers' burden and alexithymia levels were significantly associated with the participating caregivers' suicide probability. CONCLUSIONS This study demonstrates that approximately one out of every five caregivers was at risk for suicide. Therefore, hospital and community-based intervention strategies to support caregivers should be developed.
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Relationship Satisfaction in People with Parkinson's Disease and Their Caregivers: A Cross-Sectional Observational Study. Brain Sci 2021; 11:brainsci11060822. [PMID: 34205764 PMCID: PMC8234945 DOI: 10.3390/brainsci11060822] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/06/2021] [Accepted: 06/18/2021] [Indexed: 01/01/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder, which leads to reduced health-related quality of life (HR-QoL) and autonomy in advanced stages of the disease. Hence, people with PD (PwPD) are in need of help, which is often provided by informal caregivers, especially spouses. This might influence the relationship satisfaction in patients and their spousal caregivers. Additionally, previous studies have shown that a reduced relationship satisfaction may result in mental disorders and reduced physical health. The aim of this study is to identify factors influencing PwPD and their caregivers' relationship satisfaction in a cross-sectional observational study. Analyses revealed an overall satisfying relationship, measured by the Quality of Marriage Index, in PwPD (n = 84) and their caregivers (n = 79). Relationship satisfaction in PwPD mildly decreased with reduced HR-QoL and more severe depressive symptoms. Reduced relationship satisfaction in caregivers was significantly associated with decreased HR-QoL, higher caregiver burden, more severe depressive symptoms and increased neuropsychiatric symptoms in PwPD. Further studies are needed to investigate the influence of the identified factors over time and if relationship satisfaction has a reciprocal impact on caregiver burden, HR-QoL as well as mental and physical health.
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Validation of the Parkinson's Disease Caregiver Burden Questionnaire in Progressive Supranuclear Palsy. PARKINSONS DISEASE 2021; 2021:9990679. [PMID: 34046156 PMCID: PMC8128535 DOI: 10.1155/2021/9990679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/13/2021] [Accepted: 05/04/2021] [Indexed: 01/10/2023]
Abstract
Progressive supranuclear palsy (PSP) is an atypical Parkinson syndrome with axial akinetic-rigid symptoms, early postural instability, and ocular motor impairments. Patients experience a rapid loss of autonomy and care dependency; thus, caregivers must assist in the activities of daily living early in the course of the disease. Caregiver burden is an extremely important factor in disease management. However, there are no specific questionnaires for assessment of caregiver burden in PSP. This study aims to validate the Parkinson's disease caregiver burden questionnaire (PDCB) as a specific measure of caregiver burden in PSP. PSP patients were assessed by the PSP rating scale, PSP quality-of-life questionnaire (PSP-QoL), Montreal cognitive assessment test (MoCA), and geriatric depression scale (GDS-15). Caregivers filled out the short form 36-health survey, GDS-15, PDCB, and the caregiver burden inventory (CBI). 22 patient caregiver pairs completed the study. PDCB showed a highly significant correlation with the CBI (r 0.911; p < 0.001). Internal reliability of the PDCB measured by Cronbach's alpha was favourable at 0.803. These data support the specificity of the PDCB in PSP caregivers. Future studies with larger sample sizes of PSP patients and caregivers and a multicentric longitudinal design should be performed to gain further insight of caregiver burden in PSP.
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Shah-Zamora D, Allen AM, Rardin L, Ivancic M, Durham K, Hickey P, Cooney JW, Scott BL, Mantri S. Mindfulness based stress reduction in people with Parkinson's disease and their care partners. Complement Ther Clin Pract 2021; 43:101377. [PMID: 33831804 DOI: 10.1016/j.ctcp.2021.101377] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 03/05/2021] [Accepted: 03/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Parkinson's Disease (PD) leads to poor quality of life and caregiver burden. Mindfulness-based stress reduction (MBSR) may improve these symptoms. We assessed the impact of a 9-week MBSR course on people with PD (PwP) and their care partners (CPs). METHODS Participants completed questionnaires at screening, at the end of the course, and at 3-month follow-up: Parkinson's Disease Quality-39 (PDQ-39, PD only), Zarit Burden Inventory (ZBI, CP only) and Mindful Attention Awareness Scale (MAAS, both). The primary outcome measure was change in PDQ-39 (for PwP) or ZBI (for CP). Patient-reported scales were analyzed quantitatively; qualitative data on perceived effectiveness was collected. RESULTS 53.8% PwP and 100% CPs completed the course. Among PwP, there was a significant reduction in MAAS(p < 0.001) and in PDQ-39 (p = 0.008). CPs experienced an increase in MAAS (p = 0.02) but no change in ZBI (p = 0.239). Qualitatively, both PwP and CPs expressed satisfaction with the course. DISCUSSION MBSR improves mindful awareness in CPs and improves health-related quality of life in PwP.
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Affiliation(s)
| | - Allison M Allen
- Duke University Hospital (DUH) Case Management, Duke Health, USA
| | - Lacy Rardin
- Duke University Hospital (DUH) Case Management, Duke Health, USA
| | - Margaret Ivancic
- Duke University Hospital (DUH) Case Management, Duke Health, USA
| | - Katie Durham
- Duke University Hospital (DUH) Case Management, Duke Health, USA
| | - Patrick Hickey
- Department of Neurology, Duke University School of Medicine, USA
| | - Jeffrey W Cooney
- Department of Neurology, Duke University School of Medicine, USA
| | - Burton L Scott
- Department of Neurology, Duke University School of Medicine, USA
| | - Sneha Mantri
- Department of Neurology, Duke University School of Medicine, USA.
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One Year Trajectory of Caregiver Burden in Parkinson's Disease and Analysis of Gender-Specific Aspects. Brain Sci 2021; 11:brainsci11030295. [PMID: 33652825 PMCID: PMC7996933 DOI: 10.3390/brainsci11030295] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) is a slowly progressive neurodegenerative movement disorder that leads to impairments in activities of daily living. In addition to reducing patients' quality of life, this disease also affects caregivers' well-being. Until recently, caregiver burden was mainly assessed by generic questionnaires, which do not take the characteristics of the chronic disease into consideration. In the case of PD, this issue has been addressed by the introduction of the "Parkinson's disease caregiver burden" questionnaire (PDCB). Data on longitudinal trajectories of caregiver burden are still missing in the literature. In this study, we assessed the one-year trajectory of caregiver burden by the PDCB as a disease-specific questionnaire. Further, gender-specific aspects of caregiver burden were analyzed by applying a caregiver task questionnaire. PDCB total score (n = 84 patients and caregivers) did not significantly change from baseline (30.4) to one year at follow-up (31.5). No significant difference was detected between female and male caregivers in global burden and-specific caregiver tasks. Our data showed only a mild increase of caregiver burden in the timeframe of one year. Gender-specific differences do not seem to impact-specific caregiver tasks in the presented study population.
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Abstract
Humans are highly adept at differentiating, regulating, and responding to their emotions. At the core of all these functions is emotional awareness: the conscious feeling states that are central to human mental life. Disrupted emotional awareness-a subclinical construct commonly referred to as alexithymia-is present in a range of psychiatric and neurological disorders and can have a deleterious impact on functional outcomes and treatment response. This chapter is a selective review of the current state of the science on alexithymia. We focus on two separate but related issues: (i) the functional deficits associated with alexithymia and what they reveal about the importance of emotional awareness for shaping normative human functioning, and (ii) the neural correlates of alexithymia and what they can inform us about the biological bases of emotional awareness. Lastly, we outline challenges and opportunities for alexithymia research, focusing on measurement issues and the potential utility of formal computational models of emotional awareness for advancing the fields of clinical and affective science.
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Affiliation(s)
- Jeremy Hogeveen
- Department of Psychology and Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM, United States.
| | - Jordan Grafman
- Cognitive Neuroscience Laboratory, Brain Injury Research, Shirley Ryan AbilityLab, Chicago, IL, United States; Departments of Physical Medicine and Rehabilitation, Neurology, and Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Alvarado-Bolaños A, Cervantes-Arriaga A, Zuazua-Vidal L, Esquivel-Zapata Ó, Alcocer-Salas Á, Rodríguez-Violante M. Determinants and impact of alexithymia on quality of life in Parkinson's disease. Neurologia 2020; 38:S0213-4853(20)30338-8. [PMID: 33317969 DOI: 10.1016/j.nrl.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Alexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease. METHODS Subjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model. RESULTS 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p<0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL. CONCLUSIONS Alexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.
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Affiliation(s)
- A Alvarado-Bolaños
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - A Cervantes-Arriaga
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - L Zuazua-Vidal
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Ó Esquivel-Zapata
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Á Alcocer-Salas
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - M Rodríguez-Violante
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; Movement Disorder Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
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