Skip to main content

Advertisement

Log in

Impact of psychiatric symptoms and sleep disorders on the quality of life of patients with Parkinson’s disease

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

The objective of this study is to assess how the non-motor symptoms of Parkinson’s disease (PD), such as depression, cognitive deterioration, neuropsychiatric and sleep disorders, affect the quality of life, and to compare them with the motor symptoms in order to determine their real impact. A cross-sectional study was designed including 99 patients (mean age 68.5 ± 9.9 years, duration of disease 8.7 ± 6.2 years). Demographic data, onset of PD, years on treatment with levodopa (LD), class of dopaminergic drug prescribed, and dosages were obtained. The following scales were used: quality of life (PDQ-39), Unified Parkinson’s Disease Rating Scale (UPDRS I–IV), Parkinson Disease Sleep Scale (PDSS) and daytime sleepiness (Epworth), Mini-Mental State Examination, depression (HAM-D), and the neuropsychiatric inventory (NPI-10). The PDQ-39 summary index (PDQ-39 SI) was 24.7 ± 13.2. A linear regression model including all variables showed that four independent variables accounted for 67.2% of the variance in the PDQ-39 SI (F = 33,277; p < 0.001): NPI, PDSS, UPDRS IV, and UPDRS I. When sub-items of the NPI, PDSS and UPDRS IV scales are analyzed, significant correlations (p < 0.001) are found between the PDQ-39 SI and depression, agitation, apathy, anxiety, hallucinations, delusions, incontinence of urine, morning painful posturing, restlessness in bed, morning fatigue, duration of off periods, unpredictable and predictable off periods, early morning dystonia, and sudden off periods. Neuropsychiatric symptoms, especially depression, nighttime sleep disorders such as urinary incontinence, nighttime restlessness, morning fatigue and somnolence, off-period dystonia and motor fluctuations are the variables that most affect the quality of life of patients with PD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP, Bottacchi E, Cannas A, Ceravolo G, Ceravolo R, Cicarelli G, Gaglio RM, Giglia RM, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, Dotto PD (2009) The PRIAMO study: a multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson’s disease. Mov Disord 24:1641–1649

    Article  PubMed  Google Scholar 

  2. Behari M, Srivastava AK, Pandey RM (2005) Quality of life in patients with Parkinson’s disease. Parkinsonism Relat Disord 11:221–226

    Article  PubMed  CAS  Google Scholar 

  3. Chapuis S, Ouchchane L, Metz O, Gerbaud L, Durif F (2005) Impact of the motor complications of Parkinson’s disease on the quality of life. Mov Disord 20:224–230

    Article  PubMed  Google Scholar 

  4. Chaudhuri KR, Pal S, DiMarco A, Whately-Smith C, Bridgman K, Mathew R, Pezzela FR, Forbes A, Hogl B, Trenkwalder C (2002) The Parkinson’s disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 73:629–635

    Article  PubMed  CAS  Google Scholar 

  5. Cubo E, Rojo A, Ramos S, Quintana S, Gonzalez M, Kompoliti K, Aguilar M (2002) The importance of educational and psychological factors in Parkinson’s disease quality of life. Eur J Neurol 9:589–593

    Article  PubMed  CAS  Google Scholar 

  6. Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K, Daniels C, Deutschlander A, Dillmann U, Eisner W, Gruber D, Hamel W, Herzog J, Hilker R, Klebe S, Kloss M, Koy J, Krause M, Kupsch A, Lorenz D, Lorenzl S, Mehdorn HM, Moringlane JR, Oertel W, Pinsker MO, Reichmann H, Reuss A, Schneider GH, Schnitzler A, Steude U, Sturm V, Timmermann L, Tronnier V, Trottenberg T, Wojtecki L, Wolf E, Poewe W, Voges J (2006) A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 355:896–908

    Article  PubMed  CAS  Google Scholar 

  7. Dujardin K, Sockeel P, Devos D, Delliaux M, Krystkowiak P, Destee A, Defebvre L (2007) Characteristics of apathy in Parkinson’s disease. Mov Disord 22:778–784

    Article  PubMed  Google Scholar 

  8. Fahn S, Elton RL (1987) Recent developments in Parkinson’s disease. Macmillan Health Care Information, Florham Park, pp 153–164

    Google Scholar 

  9. Forsaa EB, Larsen JP, Wentzel-Larsen T, Herlofson K, Alves G (2008) Predictors and course of health-related quality of life in Parkinson’s disease. Mov Disord 23:1420–1427

    Article  PubMed  Google Scholar 

  10. Gagnon JF, Fantini ML, Bedard MA, Petit D, Carrier J, Rompre S, Decary A, Panisset M, Montplaisir J (2004) Association between waking EEG slowing and REM sleep behavior disorder in PD without dementia. Neurology 62:401–406

    PubMed  Google Scholar 

  11. Gagnon JF, Vendette M, Postuma RB, Desjardins C, Massicotte-Marquez J, Panisset M, Montplaisir J (2009) Mild cognitive impairment in rapid eye movement sleep behavior disorder and Parkinson’s disease. Ann Neurol 66:39–47

    Article  PubMed  Google Scholar 

  12. Gomez-Esteban JC, Zarranz JJ, Lezcano E, Tijero B, Luna A, Velasco F, Rouco I, Garamendi I (2007) Influence of motor symptoms upon the quality of life of patients with Parkinson’s disease. Eur Neurol 57:161–165

    Article  PubMed  CAS  Google Scholar 

  13. Gomez-Esteban JC, Zarranz JJ, Lezcano E, Velasco F, Ciordia R, Rouco I, Losada J, Bilbao I (2006) Sleep complaints and their relation with drug treatment in patients suffering from Parkinson’s disease. Mov Disord 21:983–988

    Article  PubMed  Google Scholar 

  14. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184

    Article  PubMed  CAS  Google Scholar 

  15. Katzenschlager R, Schrag A, Evans A, Manson A, Carroll CB, Ottaviani D, Lees AJ, Hobart J (2007) Quantifying the impact of dyskinesias in PD: the PDYS-26: a patient-based outcome measure. Neurology 69:555–563

    Article  PubMed  CAS  Google Scholar 

  16. Klepac N, Trkulja V, Relja M, Babic T (2008) Is quality of life in non-demented Parkinson’s disease patients related to cognitive performance? A clinic-based cross-sectional study. Eur J Neurol 15:128–133

    Article  PubMed  CAS  Google Scholar 

  17. Lieberman A (2006) Are dementia and depression in Parkinson’s disease related? J Neurol Sci 248:138–142

    Article  PubMed  Google Scholar 

  18. Marras C, McDermott MP, Rochon PA, Tanner CM, Naglie G, Lang AE (2008) Predictors of deterioration in health-related quality of life in Parkinson’s disease: results from the DATATOP trial. Mov Disord 23:653–659 quiz 776

    Article  PubMed  Google Scholar 

  19. Martinez-Martin P, Frades Payo B (1998) Quality of life in Parkinson’s disease: validation study of the PDQ-39 Spanish version, The Grupo Centro for Study of Movement Disorders. J Neurol 245(Suppl 1):S34–S38

    Article  PubMed  Google Scholar 

  20. Martinez-Martin P, Salvador C, Menendez-Guisasola L, Gonzalez S, Tobias A, Almazan J, Chaudhuri KR (2004) Parkinson’s Disease Sleep Scale: validation study of a Spanish version. Mov Disord 19:1226–1232

    Article  PubMed  Google Scholar 

  21. Muslimovic D, Post B, Speelman JD, Schmand B, de Haan RJ (2008) Determinants of disability and quality of life in mild to moderate Parkinson disease. Neurology 70:2241–2247

    Article  PubMed  CAS  Google Scholar 

  22. Pfeiffer RF (2009) Parkinson disease. Nonmotor symptoms in Parkinson disease: the PRIAMO study. Nat Rev Neurol 5:531–532

    Article  PubMed  Google Scholar 

  23. Pi J, Olive JM, Esteban M (1994) Mini Mental State Examination: association of the score obtained with the age and degree of literacy in an aged population. Med Clin (Barc) 103:641–644

    CAS  Google Scholar 

  24. Postuma RB, Gagnon JF, Vendette M, Charland K, Montplaisir J (2008) REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features. J Neurol Neurosurg Psychiatry 79:1117–1121

    Article  PubMed  CAS  Google Scholar 

  25. Postuma RB, Gagnon JF, Vendette M, Montplaisir JY (2009) Markers of neurodegeneration in idiopathic rapid eye movement sleep behaviour disorder and Parkinson’s disease. Brain 132:3298–3307

    Article  PubMed  CAS  Google Scholar 

  26. Rahman S, Griffin HJ, Quinn NP, Jahanshahi M (2008) Quality of life in Parkinson’s disease: the relative importance of the symptoms. Mov Disord 23:1428–1434

    Article  PubMed  Google Scholar 

  27. Ramos-Brieva JA, Cordero-Villafafila A (1988) A new validation of the Hamilton Rating Scale for Depression. J Psychiatr Res 22:21–28

    Article  PubMed  CAS  Google Scholar 

  28. Ravina B, Camicioli R, Como PG, Marsh L, Jankovic J, Weintraub D, Elm J (2007) The impact of depressive symptoms in early Parkinson disease. Neurology 69:342–347

    Article  PubMed  CAS  Google Scholar 

  29. Schrag A (2006) Quality of life and depression in Parkinson’s disease. J Neurol Sci 248:151–157

    Article  PubMed  Google Scholar 

  30. Simuni T, Sethi K (2008) Nonmotor manifestations of Parkinson’s disease. Ann Neurol 64:65–80

    Article  Google Scholar 

  31. Suzuki K, Miyamoto M, Miyamoto T, Okuma Y, Hattori N, Kamei S, Yoshii F, Utsumi H, Iwasaki Y, Iijima M, Hirata K (2009) Correlation between depressive symptoms and nocturnal disturbances in Japanese patients with Parkinson’s disease. Parkinsonism Relat Disord 15:15–19

    Article  PubMed  Google Scholar 

  32. The Global Parkinson’s Disease Survey (GPDS) Steering Committee (2002) Factors impacting on quality of life in Parkinson’s disease: results from an international survey. Mov Disord 17:60–67

    Article  Google Scholar 

  33. Vilalta-Franch J, Lozano-Gallego M, Hernandez-Ferrandiz M, Llinas-Regla J, Lopez-Pousa S, Lopez OL (1999) The Neuropsychiatric Inventory: psychometric properties of its adaptation into Spanish. Rev Neurol 29:15–19

    PubMed  CAS  Google Scholar 

  34. Yoritaka A, Ohizumi H, Tanaka S, Hattori N (2009) Parkinson’s disease with and without REM sleep behaviour disorder: are there any clinical differences? Eur Neurol 61:164–170

    Article  PubMed  Google Scholar 

  35. Zadikoff C, Fox SH, Tang-Wai DF, Thomsen T, de Bie RM, Wadia P, Miyasaki J, Duff-Canning S, Lang AE, Marras C (2008) A comparison of the mini mental state exam to the Montreal cognitive assessment in identifying cognitive deficits in Parkinson’s disease. Mov Disord 23:297–299

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

There are no funding sources or potential conflicts of interest from each author that relate to the research covered in the article submitted.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Juan Carlos Gómez-Esteban.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gómez-Esteban, J.C., Tijero, B., Somme, J. et al. Impact of psychiatric symptoms and sleep disorders on the quality of life of patients with Parkinson’s disease. J Neurol 258, 494–499 (2011). https://doi.org/10.1007/s00415-010-5786-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-010-5786-y

Keywords

Navigation