Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity
| Autor: | Brian B. Koo, Sarah Kellner, Sarah L. Morgan, Stephanie Cosentino, Elan D. Louis, Tess E K Cersonsky, John M. de Figueiredo |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Movement disorders Essential Tremor Learned helplessness Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Prevalence medicine Humans Depression (differential diagnoses) Aged Aged 80 and over Essential tremor business.industry Middle Aged medicine.disease Confidence interval Psychiatry and Mental health Demoralization 030220 oncology & carcinogenesis Anxiety Female Geriatric Depression Scale Neurology (clinical) medicine.symptom business Psychosocial 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | CNS Spectrums. 25:16-23 |
| ISSN: | 2165-6509 1092-8529 |
| DOI: | 10.1017/s1092852918001633 |
| Popis: | Objective.Essential tremor (ET) is associated with psychological difficulties, including anxiety and depression. Demoralization (feelings of helplessness, hopelessness, inability to cope), another manifestation of psychological distress, has yet to be investigated in ET. Our objectives are to (1) estimate the prevalence of demoralization in ET, (2) assess its clinical correlates, and (3) determine whether demoralization correlates with tremor severity.Methods.We administered the Kissane Demoralization Scale (KDS-II) and several psychosocial evaluations (ie, scales assessing subjective incompetence, resilience, and depression [eg, Geriatric Depression Scale]) to 60 ET subjects. Tremor was assessed with a disability score and total tremor score. KDS-II >8 indicated demoralization.Results.Among 60 ET subjects (mean age = 70.2 ± 6.8 years), the prevalence of demoralization was 13.3%, 95% confidence interval = 6.9–24.2%. Although there was overlap between demoralization and depression (10% of the sample meeting criteria for both), 54% of depressed subjects were not demoralized, and 25% of demoralized subjects were not depressed. Demoralization correlated with psychological factors, but demoralized subjects did not have significantly higher total tremor scores, tremor disability scores, or years with tremor.Conclusions.Demoralization has a prevalence of 13.3% in ET, similar to that in other chronic or terminal illnesses (eg, cancer 13–18%, Parkinson’s disease 18.1%, coronary heart disease 20%). Demoralization was not a function of increased tremor severity, suggesting that it is a separable construct, which could dictate how a patient copes with his/her disease. These data further our understanding of the psychological and psychosocial correlates of ET. |
| Databáze: | OpenAIRE |
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