The primary aim of this research was to investigate the perceived interaction between physical and psychological symptoms in PD, as reported by PwP, their carers, and physiotherapists. Additionally, the study sought to explore the barriers faced by physiotherapists in assessing and making onward referrals for patients experiencing psychological symptoms.
Two cross-sectional online surveys were conducted: one involving 251 PwP and 61 carers, and another with 125 UK-based physiotherapists. The PwP and carer survey examined reported diagnosed and undiagnosed psychological symptoms, their onset, and the perceived impact of physical and psychological symptoms on each other. The physiotherapist survey assessed individual experiences of working with PwP, mental health training, outcome measures used, and barriers to making onward referrals for psychological symptoms. Descriptive statistics summarized the responses, enabling a comparative analysis of perspectives.
Among PwP and carers, 38.5% reported at least one diagnosed psychological condition, while 44.6% experienced undiagnosed psychological symptoms, predominantly anxiety and depression. Approximately 50% of respondents perceived a bi-directional interaction between physical and psychological symptoms, especially among those with first-hand experience of psychological symptoms. Notably, while both PwP and carers acknowledged the impact of psychological symptoms, carers perceived the impact of physical symptoms as more substantial.
Physiotherapists surveyed reported extensive experience working with PwP, utilizing outcome measures primarily for physical function assessment rather than non-motor symptoms. Despite 92% recognizing a relationship between physical and psychological symptoms, 64% indicated barriers to making onward referrals for psychological issues. The most commonly used physical outcome measure was the Timed-Up-and-Go, while the Hospital Anxiety and Depression Scale was frequently used for psychological assessment.
This study highlights a perceived interaction between physical and psychological symptoms in PD among PwP, carers, and physiotherapists. Despite the recognition of psychological symptoms, there is a notable gap in their assessment within clinical practice, compounded by barriers to referrals when issues are identified. Enhanced awareness and training for physiotherapists regarding psychological symptoms alongside improved referral pathways are essential for comprehensive care.
The findings underscore the need for improved assessment protocols for psychological symptoms in physiotherapy practice. Addressing the identified barriers to onward referrals could lead to better management of both physical and psychological aspects of PD. Future research should focus on developing targeted interventions and training programs for physiotherapists to facilitate comprehensive care for PwP. By enhancing physiotherapists' ability to assess and address psychological symptoms, the overall quality of care for individuals with Parkinson's disease can be significantly improved, ultimately leading to optimized patient outcomes and quality of life.
Symptom Interaction
Mental Health
