@article{ref1,
title="From Perceived Stress to Demoralization in Parkinson Disease: A Path Analysis",
journal="Frontiers in psychiatry",
year="2022",
author="de Figueiredo, J.M. and Zhu, B. and Patel, A. and Kohn, R. and Koo, B.B. and Louis, E.D.",
volume="13",
number="",
pages="-",
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. <br><br>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. <br><br>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). <br><br>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.<p /><p>Language: en</p>",
language="en",
issn="1664-0640",
doi="10.3389/fpsyt.2022.876445",
url="http://dx.doi.org/10.3389/fpsyt.2022.876445"
}