Angst, depressie en slaapproblemen bij de ziekte van Parkinson: een complexe interactie tussen lichaam en geest

BACKGROUND Anxiety and depression in Parkinson’s disease (pd) are often unrecognized, partially due to a complex relationship with sleep disorders and other pd-related symptoms. AIM To gain more insight in anxiety, depression and sleep disorders in pd, their reciprocal interaction and relationship with other (non)motor symptoms. METHOD With three epidemiological studies in this thesis article we describe: the symptom dimensions of anxiety, motor symptoms and autonomic failure; predictors of the course of anxiety; and the temporal relationship between anxiety, depression and insomnia in pd. RESULTS Anxiety in pd has one affective and various somatic symptom dimensions. There is a symptomatic overlap between anxiety and symptoms of motor and autonomic dysfunctions. Anxiety, depression and impulsive-compulsive behaviors in de novo pd show a parallel course. Cognitive dysfunctions and rem-sleep behaviour disorder are risk factors for anxiety in pd patients. The relationship between insomnia and anxiety and depression is bi-directional. CONCLUSION There is an overlap, co-morbidity and interaction between anxiety, depression, sleep disorders and (non)motor symptoms, which warrants a multi-disciplinary approach to pd. Sleep disorders and cognitive dysfunctions may provide starting points for treatment and preventions of anxiety in pd.