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Cognition, coping, and outcome in Parkinson's disease

  • Catherine S. Hurt (a1), Sabine Landau (a2), David J. Burn (a3), John V. Hindle (a4), Mike Samuel (a5), Ken Wilson (a6) and Richard G. Brown (a7)...

Abstract

Background: Cognitive impairment and depression are common and disabling non-motor symptoms of Parkinson's disease (PD). Previous studies have shown associations between them but the nature of the relationship remains unclear. In chronic illness, problem- or task-oriented coping strategies are associated with better outcome but often require higher level cognitive functioning. The present study investigated, in a sample of patients with PD, the relationships between cognitive function, choice of coping strategies, and a broad index of outcome including depression, anxiety, and health-related quality of life (QoL). It was hypothesized that the coping strategy used could mediate the association between cognition and outcome.

Methods: 347 participants completed the Coping Inventory for Stressful Situations, the Hospital Anxiety and Depression Scale, the Parkinson's Disease Questionnaire-8, the Unified Parkinson's Disease Rating Scale, and the Addenbrooke's Cognitive Examination–Revised. Structural Equation Modeling was used to test the hypothesized model of cognition, coping, and outcome based on a direct association between cognition and outcome and an indirect association mediated by coping.

Results: Overall, poorer cognition predicted less use of task-oriented coping, which predicted worse outcome (a latent variable comprised of higher depression and anxiety and lower QoL). The analyses suggested a small indirect effect of cognition on outcome mediated by coping.

Conclusions: The findings suggest that patients who fail to employ task-oriented coping strategies may be at greater risk of depression, anxiety, and poor health-related QoL. Even mild to moderate cognitive impairment may contribute to reduced use of task-oriented coping. Suitably adapted cognitive–behavioral approaches may be useful to enable the use of adaptive coping strategies in such patients.

Copyright

Corresponding author

Correspondence should be addressed to: Dr. Catherine S. Hurt, Health Services Research, Room 224, College Building, City University London, Northampton Square, London EC1V 0HB, UK. Phone: +44-20-7040-0883; Fax: +44-20-7040-0875. Email: Catherine.hurt.1@city.ac.uk.

References

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Aarsland, D., Zaccai, J. and Brayne, C. (2005). A systematic review of prevalence studies of dementia in Parkinson's disease. Movement Disorders, 20, 12551263.
Arean, P. A. and Cook, B. L. (2002). Psychotherapy and combined psychotherapy/pharmacotherapy for late life depression. Biological Psychiatry, 52, 293303.
Arean, P. A., Perri, M. G., Nezu, A. M., Schein, R. L., Christopher, F. and Joseph, T. X. (1993). Comparative effectiveness of social problem-solving therapy and reminiscence therapy as treatments for depression in older adults. Journal of Consulting and Clinical Psychology, 61, 10031010.
Baron, R. and Kenny, D. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 11731182.
Bollen, K. A. (1990). Overall fit in covariance structure model: two types of sample-size effects. Psychological Bulletin, 107, 256259.
Brown, R. G. et al. (2011). Depression and anxiety related subtypes in Parkinson's disease. Journal of Neurology, Neurosurgery and Psychiatry, 82, 803809.
Bucks, R. S., Cruise, K. E., Skinner, T. C., Loftus, A. M., Barker, R. A. and Thomas, M. G. (2011). Coping processes and health-related quality of life in Parkinson's disease. International Journal of Geriatric Psychiatry, 26, 247255.
Byrne, B. (2001). Structural Equation Modeling with AMOS: Basic Concepts, Applications and Programming. Mahwah, NJ: Lawrence Erlbaum.
Chaudhuri, K. R., Healy, D. G. and Schapira, A. H. (2006). Non-motor symptoms of Parkinson's disease: diagnosis and management. Lancet Neurology, 5, 235245.
Craigie, M. A. and Nathan, P. (2009). A nonrandomized effectiveness comparison of broad-spectrum group CBT to individual CBT for depressed outpatients in a community mental health setting. Behavior Therapy, 40, 302314.
Dobkin, R. D. et al. (2011). Cognitive-behavioral therapy for depression in parkinson's disease: a randomized, controlled trial. American Journal of Psychiatry, 168, 10661074.
Dobkin, R. D. et al. (2012). Predictors of treatment response to cognitive-behavioral therapy for depression in Parkinson's disease. Journal of Consulting and Clinical Psychology. Epublished ahead of print, doi: 10.1037/a0027695.
Endler, N. and Parker, J. (1999). Coping Inventory for Stressful Situations: Manual. Toronto: MHS.
Fahn, S. and Elton, R. L. (1987). Unified Parkinson's disease rating scale. In Fahn, S., Marsden, C. D., Goldstein, M. and Calne, D. (eds.), Recent Development in Parkinson's Disease (pp. 153163). Florham Park, NJ: Macmillan Healthcare Information.
Felton, B. J. and Revenson, T. A. (1984). Coping with chronic illness: a study of illness controllability and the influence of coping strategies on psychological adjustment. Journal of Consulting and Clinical Psychology, 52, 343353.
Folkman, S. and Lazarus, R. S. (1988). The relationship between coping and emotion: implications for theory and research. Social Science and Medicine, 26, 309317.
Foltynie, T., Brayne, C. E., Robbins, T. W. and Barker, R. A. (2004). The cognitive ability of an incident cohort of Parkinson's patients in the UK: the CamPaIGN study. Brain, 127, 550560.
Goretti, B. et al. (2010). Impact of cognitive impairment on coping strategies in multiple sclerosis. Clinical Neurology and Neurosurgery, 112, 127130.
Hinnell, C., Hurt, C. S., Landau, S., Brown, R. G. and Samuel, M. (2012). Non-motor vs motor symptoms: how much do they matter to health status in Parkinson's disease? Movement Disorders, 27, 236241.
Hughes, A. J. et al. (1992). Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. Journal of Neurology, Neurosurgery and Psychiatry, 55, 181184.
Hurt, C. S. et al. (2011). Coping in Parkinson's disease: an examination of the coping inventory for stressful situations. International Journal of Geriatric Psychiatry, 26, 10301037.
Jenkinson, C., Fitzpatrick, R., Petrone, A., Greenhall, R. and Hyman, N. (1997). The PDQ-8: development and validation of a short-form Parkinson's disease questionnaire. Psychology and Health, 12, 805814.
Laidlaw, K. (2001). An empirical review of cognitive therapy for late life depression: does research evidence suggest adaptations are necessary for cognitive therapy with older adults? Clinical Psychology & Psychotherapy, 8, 114.
Mackin, R. S., Arean, P. and Elite-Marcandonatou, A. (2006). Problem solving therapy for the treatment of depression for a patient with Parkinson's disease and mild cognitive impairment: a case study. Neuropsychiatric Disorders and Treatment, 2, 375379.
Mioshi, E., Dawson, K., Mitchell, J., Arnold, R. and Hodges, J. R. (2006). The Addenbrooke's Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. International Journal of Geriatric Psychiatry, 21, 10781085.
Mohlman, J. et al. (2010). A novel approach to treating anxiety and enhancing executive skills in an older adult with Parkinson's disease. Clinical Case Studies, 9, 7490.
Mohlman, J., Chazin, D. and Georgescu, B. (2011). Feasibility and acceptance of a nonpharmacological cognitive remediation intervention for patients with Parkinson disease. Journal of Geriatric Psychiatry and Neurology, 24, 9197.
Mondolo, F., Jahanshahi, M., Grana, A., Biasutti, E., Cacciatori, E. and Di Benedetto, P. (2006). The validity of the hospital anxiety and depression scale and the geriatric depression scale in Parkinson's disease. Behavioural Neurology, 17, 109115.
Montel, S., Bonnet, A. M. and Bungener, C. (2009). Quality of life in relation to mood, coping strategies, and dyskinesia in Parkinson's disease. Journal of Geriatric Psychiatry and Neurology, 22, 95102.
Montel, S. and Bungener, C. (2008). To what extent does frontal type executive impairment affect coping strategies in Parkinson's disease? European Journal of Neurology, 15, 11311134.
ONS (2001). The National Statistics Socio-Economic Classification (NS-SEC). Newport: ONS.
Parkinson's Disease Society (2007). A Professional's Guide to Parkinson's Disease. Available at: http://www.parkinsons.org.uk/pdf/B126_Professionalsguide.pdf.
Raggi, A. et al. (2010). Functioning and disability in Parkinson's disease. Disability and Rehabilitation, 32, S33S41.
Reyes, M. A., Lloret, S. P., Gerscovich, E. R., Martin, M. E., Leiguarda, R. and Merello, M. (2009). Addenbrooke's Cognitive Examination validation in Parkinson's disease. European Journal of Neurology, 16, 142147.
Santangelo, G. et al. (2009). Relationship between depression and cognitive dysfunctions in Parkinson's disease without dementia. Journal of Neurology, 256, 632638.
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361370.

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Cognition, coping, and outcome in Parkinson's disease

  • Catherine S. Hurt (a1), Sabine Landau (a2), David J. Burn (a3), John V. Hindle (a4), Mike Samuel (a5), Ken Wilson (a6) and Richard G. Brown (a7)...

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