Correlates of Psychological Distress in Patients with Parkinson's Disease During the COVID-19 Outbreak

Background: Following the severe consequences of the COVID-19 outbreak, on March 9, 2020, the Italian government implemented extraordinary measures to limit viral transmission, including restrictive quarantine measures. This resulted in a rapid and profound change of people's daily lives. Objective: We assessed the psychological impact of the 40-day quarantine in a large cohort of patients with Parkinson's disease (PD) and caregivers. Moreover, we analyzed whether prelockdown clinical features may be associated with subjective response of patients with PD to this traumatic event. Methods: A total of 94 patients with PD were enrolled in the study. The Impact of Event Scale-Revised, the Kessler Psychological Distress Scale, and the 12-item Zarit Burden Inventory were obtained from patients and caregivers by email. A multivariate regression analysis was performed to determine whether prelockdown clinical motor and nonmotor features were associated with the psychological impact of lockdown. Results:Regression analyses showed that prelockdown levels of anxiety, treatment-related motor complications, patients' quality of life, and lockdown hours per day were significantly associated with psychological impact measures of the 40-day quarantine. In addition, we showed that caregiver burden was correlated with overall patient autonomy and attention/memory impairment. Conclusions:We identified specific PD motor and nonmotor features potentially predisposing to higher psychological impact of stressful situations, such as quarantine. This may help guide postpandemic interventions and preventive strategies to avoid further impairment of psychological well-being in patients with PD.