Citation

de Figueiredo JM, Zhu B, Patel A, Kohn R, Koo BB, Louis ED. Front. Psychiatry 2022; 13.

Copyright

(Copyright © 2022, Frontiers Media)

DOI

10.3389/fpsyt.2022.876445

PMID

unavailable

Abstract

OBJECTIVES: The objective of this study was to determine whether depression and anxiety are mediators between perceived stress and demoralization via a loss of the cognitive map to get out of the predicament manifesting as subjective incompetence.

METHODS: Ninety-five consecutive outpatients with Parkinson's disease were evaluated for perceived stress, depression, anxiety, subjective incompetence, and demoralization using reliable and valid scales. Inclusion criteria were ages 40-90, intact cognition, and no current history of substance use. The setting was a Movement Disorders Clinic at a university-affiliated hospital. The outcome variable was demoralization, selected a priori. Mediators between perceived stress and demoralization were examined using path analysis.

RESULTS: Depression, anxiety, and subjective incompetence were mediators between perceived stress and demoralization. Among all variables, subjective incompetence was the largest contributor to demoralization. Depression connected to demoralization indirectly via subjective incompetence (β = 0.25, p < 0.001), whereas anxiety bypassed subjective incompetence (β = −0.01, p = 0.882), connecting directly to demoralization (β = 0.37, p = 0.008).

CONCLUSION: Early treatment and reversal of subjective incompetence and anxiety could potentially prevent the escalation of demoralization and the associated disruption in health-related quality of life and eventual suicide. Copyright © 2022 de Figueiredo, Zhu, Patel, Kohn, Koo and Louis.

Language: en

Keywords

adult; human; cognition; suicide; female; male; aged; quality of life; depression; anxiety; stress; substance use; hopelessness; demoralization; outpatient; major clinical study; controlled study; middle aged; anxiety disorder; cohort analysis; Parkinson disease; university hospital; patient participation; Parkinson's disease; Article; clinical evaluation; very elderly; physiological stress; subjective incompetence; suicide/suicidal ideation/suicidal behavior