Difficulties in activities of daily living are associated with stigma in patients with Parkinson's disease who are candidates for deep brain stimulation

Braz J Psychiatry. 2020 Apr;42(2):190-194. doi: 10.1590/1516-4446-2018-0333. Epub 2019 Aug 5.

Abstract

Objective: Parkinson's disease (PD) is often accompanied by stigma, which could contribute to a worse prognosis. The objective of this study is to identify the variables associated with stigma in PD patients who are candidates for deep brain stimulation (DBS).

Methods: We investigated sociodemographic and clinical variables associated with stigma in a sample of 54 PD patients indicated for DBS. The independent variables were motor symptoms assessed by the Movement Disorder Society-sponsored revision of the Unified Parkinson Disease Rating Scale (MDS-UPDRS III), depressive symptoms measured by the Hospital Anxiety and Depression Scale, age, disease duration and the presence of a general medical condition. The Mobility, Activities of daily living and Emotional well-being domains of the 39-item Parkinson's Disease Questionnaire (PDQ-39) were also investigated as independent variables, and the Stigma domain of the PDQ-39 scale was considered the outcome variable.

Results: After multiple linear regression analysis, activities of daily living remained associated with the Stigma domain (B = 0.42 [95%CI 0.003-0.83], p = 0.048). The full model accounted for 15% of the variance in the Stigma domain (p = 0.03).

Conclusions: Although causal assumptions are not appropriate for cross-sectional studies, the results suggest that ADL difficulties could contribute to greater stigma in PD patients with refractory motor symptoms who are candidates for DBS.

MeSH terms

  • Activities of Daily Living / psychology*
  • Aged
  • Cross-Sectional Studies
  • Deep Brain Stimulation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / psychology*
  • Parkinson Disease / therapy*
  • Quality of Life / psychology*
  • Severity of Illness Index
  • Social Stigma*
  • Surveys and Questionnaires
  • Treatment Outcome