The relationship between physical function and psychological symptoms in Parkinson's: A Survey of People with Parkinson’s and Carers

Background: People with Parkinson's (PwP) can experience both physical and psychological symptoms, and understanding the perspectives of people affected is crucial for improved management, and clinical outcomes. Objectives: This online survey sought to investigate whether individuals perceive a connection between physical and psychological symptoms, while also considering the influence of personal roles and past symptom experiences. Methods: A UK-wide survey of 251 PwP and 61 family/carers was conducted. The survey focused on reported diagnosed and non-diagnosed psychological symptoms experienced, their onset, and the perceived impact of physical and psychological symptoms on one another. Responses were summarised using descriptive statistics. Results: A substantial proportion of respondents reported at least one diagnosed psychological condition (38.5%) or undiagnosed psychological symptoms (44.6%) such as anxiety and depression. Half of respondents reported perceiving a bi-directional interaction between physical and psychological symptoms, with this perception most reported in people with prior experience of psychological symptoms. Our sample shows that while PwP and carers have similar views on the impact of psychological symptoms, carers perceive the impact of physical symptoms to be greater than PwP. Conclusions: PwP and carers appear to perceive an interaction between physical and psychological symptoms in Parkinson's, noting that psychological symptoms frequently precede Parkinson's diagnosis but are often under-recognised. Improved awareness of the potential link between physical and psychological symptoms in PwP may help to improve assessment, and onward referral processes to enhance care. Further research may assist in identifying potential sub-groups and allow the prediction of changes in physical and psychological presentation.