Alʹmanah Kliničeskoj Mediciny (Jul 2016)
THE РERSONALITY PROFILE OF PATIENTS WITH EARLY MANIFESTATIONS OF PARKINSON'S DISEASE
Abstract
Background: Mental disorders that sometimes may precede motor dysfunction have an important value in Parkinson's disease, especially at its earlier stages. Personality characteristics of patients with Parkinson's disease have not been studied enough and require a detailed assessment, because it is a major factor contributing to treatment efficacy. Aim: To assess personality profiles of patients with early stages of Parkinson's disease and an impact of a dopamine receptor agonist on the personality profile. Materials and methods: We assessed 33 treatment-naïve patients with early symptoms of Parkinson's disease (Hoehn-Yahr stage I and II). The following scales were used before treatment and at 1, 3 and 6 months of treatment with pramipexol: for motor disorders (UPDRS, Unified Parkinson's Disease Rating Scale), depressive disorders (MADRS, Montgomery Asberg Depression Rating Scale) and anxiety disorders (HARS, Hamilton Anxiety Rating Scale), as well as personality profile (MMPI, Minnesota Multiphasic Personality Inventory). Results: The personality profile assessed by MMPI in patients with early stage Parkinson's disease was characterized by highest T scores on scales 2 (pessimism) (74 [64; 86]), 1 (neurotic excess control) (67 [63; 74]), 3 (emotional instability) (64 [56; 70]), 7 (anxiousness) (63 [52; 70]), 8 (autism) (64 [58; 74]), 0 (introversion) (63 [59; 66]). This indicates basic pathopsychological characteristics of patients with early stages of the disease. In particular, their emotional sphere demonstrated anxiety- and depression-related affective disorders. Their personality structure was characterized by dysthymic, anxious, rigid and explosive traits, and susceptibility to hypochondriasis. With a background of a dramatic motivational conflict, frustration of high-level need in self-actualization and recognition due to a chronic disease with motor dysfunction triggered a depressive response type. Pharmacological treatment with pramipexol decreased the neurotic triad at 1 month. However, at subsequent follow-up, there was a gradual shift towards baseline parameters, in spite of a good clinical efficacy of treatment against motor disorders that indicates a stable sensitive-anxious personality accentuation. Conclusion: Early stages of Parkinson's disease are characterized by a sensitive-anxious personality structure that is quite stable. This should be taken into account when deciding on a treatment approach to these patients and consideration of potential psychotherapeutic support.
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