INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #89 Anxiety Subtypes in Parkinson’s Disease Patients Seeking Deep Brain Stimulation: Questionable Agreement Between Psychiatric Diagnoses and the State-Trait Anxiety Inventory Katie Rodriguez, University of Florida, Gainesville, United States Adrianna Ratajska, University of Florida, Gainesville, United States Rachel Schade, University of Florida, Gainesville, United States Lauren Kenney, University of Florida, Gainesville, United States Joshua Gertler, University of Florida, Gainesville, United States Justin Hilliard, University of Florida, Gainesville, United States Kelly Foote, University of Florida, Gainesville, United States Uma Suryadevara, University of Florida, Gainesville, United States Herbert Ward, University of Florida, Gainesville, United States Dawn Bowers, University of Florida, Gainesville, United States Category: Movement and Movement Disorders Keyword 1: anxiety Keyword 2: Parkinson's disease Keyword 3: neuropsychiatry Objective: Anxiety is a debilitating neuropsychiatric symptom of Parkinson’s disease (PD) that contributes to worse quality of life and increased disability. Self-report measures are often used in clinical settings to measure anxiety in PD but have been widely criticized for lacking specificity for certain anxiety subtypes (e.g., generalized, specific phobia, social). The current study sought to examine which anxiety diagnoses were most common among PD patients seeking pre-surgical evaluation for deep brain stimulation (DBS) and what proportion of these individuals endorse clinically significant anxiety symptoms on a self-report measure of dispositional anxiety, the State-Trait Anxiety Inventory-Trait (STAI-Trait). We hypothesized that Generalized Anxiety Disorder (GAD) would be the most common diagnosis and that those with GAD would be most likely to report clinically significant anxiety symptoms, given the overlap between GAD symptoms and items on the STAI-Trait. Participants and Methods: Participants included a convenience sample of 403 individuals with idiopathic PD (m=65+9 years old; 28% female; 94% white) being seen for pre-surgical evaluation to determine candidacy for DBS at the UF Fixel Institute for Neurological Diseases. All participants underwent a multi-disciplinary workup involving separate evaluations with neuropsychology and psychiatry. Anxiety diagnoses were given by psychiatrists according to the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5). Participants also completed self-report mood measures during neuropsychological evaluation, including the STAI-Trait. Standard clinical cutoffs (STAI-Trait>40) were used to determine clinically significant anxiety symptoms. Psychiatrists were unaware of participant’s performance on mood measures. Results: A total of 142 (35.2%) PD individuals received a diagnosis of anxiety by a psychiatrist according to DSM-5 criteria. Of those that received a diagnosis of anxiety, only 67 (47%) endorsed clinically significant anxiety symptoms on a self-report measure (STAI-Trait), which indicated a significant departure from equiprobability [χ²(1)=17.7, p <.001]. The most common anxiety diagnosis was GAD (N=50), with 52% endorsing clinically significant anxiety symptoms on the STAI-Trait, followed by Other Specified Anxiety Disorder (N=34; 35% above STAI-Trait cutoff), Anxiety Disorder Unspecified (N=26; 36% above STAI-Trait cutoff), Anxiety Due to General Medical Condition (N=19; 63% above STAI-Trait cutoff), Panic Disorder (N=3; 100% above STAI-Trait cutoff), Other Specified Phobia (N=3; 67% above STAI-Trait cutoff), Adjustment Disorder (N=2; 50% above STAI-Trait cutoff), Social Anxiety Disorder (N=1; 100% above STAI-Trait cutoff), and Other Mixed Anxiety Disorder (N=1; 0% above STAI-cutoff). Three individuals received two separate anxiety diagnoses (0% above STAI-Trait cutoff). Conclusions: Generalized Anxiety Disorder was the most common anxiety diagnosis in PD, consistent with our hypothesis. However, Panic Disorder and Social Anxiety Disorder had the greatest proportion of individuals who self-reported clinically significant anxiety symptoms on the STAI-Trait. While studies in non-clinical populations have also reported an association between panic/social anxiety disorders and elevated trait anxiety, only 4 out of 142 individuals with anxiety in our sample were diagnosed with these specific disorders, which is a limitation of the current study. Overall, STAI-Trait anxiety did not reliably indicate clinical anxiety as diagnosed by psychiatrists. Neuropsychologists should exhibit caution in using this measure exclusively to diagnose anxiety in PD.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #89

Anxiety Subtypes in Parkinson’s Disease Patients Seeking Deep Brain Stimulation: Questionable Agreement Between Psychiatric Diagnoses and the State-Trait Anxiety Inventory

Katie Rodriguez, University of Florida, Gainesville, United States
Adrianna Ratajska, University of Florida, Gainesville, United States
Rachel Schade, University of Florida, Gainesville, United States
Lauren Kenney, University of Florida, Gainesville, United States
Joshua Gertler, University of Florida, Gainesville, United States
Justin Hilliard, University of Florida, Gainesville, United States
Kelly Foote, University of Florida, Gainesville, United States
Uma Suryadevara, University of Florida, Gainesville, United States
Herbert Ward, University of Florida, Gainesville, United States
Dawn Bowers, University of Florida, Gainesville, United States

Category: Movement and Movement Disorders

Keyword 1: anxiety
Keyword 2: Parkinson's disease
Keyword 3: neuropsychiatry

Objective:

Anxiety is a debilitating neuropsychiatric symptom of Parkinson’s disease (PD) that contributes to worse quality of life and increased disability. Self-report measures are often used in clinical settings to measure anxiety in PD but have been widely criticized for lacking specificity for certain anxiety subtypes (e.g., generalized, specific phobia, social). The current study sought to examine which anxiety diagnoses were most common among PD patients seeking pre-surgical evaluation for deep brain stimulation (DBS) and what proportion of these individuals endorse clinically significant anxiety symptoms on a self-report measure of dispositional anxiety, the State-Trait Anxiety Inventory-Trait (STAI-Trait). We hypothesized that Generalized Anxiety Disorder (GAD) would be the most common diagnosis and that those with GAD would be most likely to report clinically significant anxiety symptoms, given the overlap between GAD symptoms and items on the STAI-Trait.

Participants and Methods:

Participants included a convenience sample of 403 individuals with idiopathic PD (m=65+9 years old; 28% female; 94% white) being seen for pre-surgical evaluation to determine candidacy for DBS at the UF Fixel Institute for Neurological Diseases. All participants underwent a multi-disciplinary workup involving separate evaluations with neuropsychology and psychiatry. Anxiety diagnoses were given by psychiatrists according to the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5). Participants also completed self-report mood measures during neuropsychological evaluation, including the STAI-Trait. Standard clinical cutoffs (STAI-Trait>40) were used to determine clinically significant anxiety symptoms. Psychiatrists were unaware of participant’s performance on mood measures.

Results:

A total of 142 (35.2%) PD individuals received a diagnosis of anxiety by a psychiatrist according to DSM-5 criteria. Of those that received a diagnosis of anxiety, only 67 (47%) endorsed clinically significant anxiety symptoms on a self-report measure (STAI-Trait), which indicated a significant departure from equiprobability [χ²(1)=17.7, p <.001]. The most common anxiety diagnosis was GAD (N=50), with 52% endorsing clinically significant anxiety symptoms on the STAI-Trait, followed by Other Specified Anxiety Disorder (N=34; 35% above STAI-Trait cutoff), Anxiety Disorder Unspecified (N=26; 36% above STAI-Trait cutoff), Anxiety Due to General Medical Condition (N=19; 63% above STAI-Trait cutoff), Panic Disorder (N=3; 100% above STAI-Trait cutoff), Other Specified Phobia (N=3; 67% above STAI-Trait cutoff), Adjustment Disorder (N=2; 50% above STAI-Trait cutoff), Social Anxiety Disorder (N=1; 100% above STAI-Trait cutoff), and Other Mixed Anxiety Disorder (N=1; 0% above STAI-cutoff). Three individuals received two separate anxiety diagnoses (0% above STAI-Trait cutoff).

Conclusions:

Generalized Anxiety Disorder was the most common anxiety diagnosis in PD, consistent with our hypothesis. However, Panic Disorder and Social Anxiety Disorder had the greatest proportion of individuals who self-reported clinically significant anxiety symptoms on the STAI-Trait. While studies in non-clinical populations have also reported an association between panic/social anxiety disorders and elevated trait anxiety, only 4 out of 142 individuals with anxiety in our sample were diagnosed with these specific disorders, which is a limitation of the current study. Overall, STAI-Trait anxiety did not reliably indicate clinical anxiety as diagnosed by psychiatrists. Neuropsychologists should exhibit caution in using this measure exclusively to diagnose anxiety in PD.