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Introduction <p>Anxiety disorders are common and disabling in Parkinson’s disease, however, systematic assessment is challenging in frontline clinical settings. The Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) includes a single-item anxiety question, but its screening performance has not been definitively established. </p> Methods <p>The performance of the MDS-UPDRS anxiety-item was compared to a reference standard – the Hamilton Anxiety Rating Scale (HARS) administered in ON and OFF motor states.</p> Results <p>The MDS-UPDRS anxiety item score ≥ 1 predicted clinically significant anxiety with sensitivity/specificity of 76.5%/53.7% in the ON state and 65.0%/62.5% in the OFF state, while a score ≥ 2 yielded a sensitivity/specificity of 39.2%/93.3% ON and 22.5%/96.3% OFF.</p> Discussion <p>The MDS-UPDRS is a pragmatic clinical screen for anxiety, useful in triaging patients in need of comprehensive anxiety assessments. This study examines the screening performance of the MDS-UPDRS and provides a framework for how the scale can be operationalized in clinical settings to optimize identification of patients with clinically significant anxiety.</p>

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Screening performance of the MDS-UPDRS anxiety item in Parkinson’s disease: Comparison to the Hamilton anxiety rating scale

  • 期刊论文

  • 发表日期：

    2026年4月16日

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  • Christopher B. Morrow,
  • Abhimanyu Mahajan,
  • Joseph Seemiller,
  • Kelly A. Mills,
  • Gregory M. Pontone

摘要

Introduction

Anxiety disorders are common and disabling in Parkinson’s disease, however, systematic assessment is challenging in frontline clinical settings. The Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) includes a single-item anxiety question, but its screening performance has not been definitively established.

Methods

The performance of the MDS-UPDRS anxiety-item was compared to a reference standard – the Hamilton Anxiety Rating Scale (HARS) administered in ON and OFF motor states.

Results

The MDS-UPDRS anxiety item score ≥ 1 predicted clinically significant anxiety with sensitivity/specificity of 76.5%/53.7% in the ON state and 65.0%/62.5% in the OFF state, while a score ≥ 2 yielded a sensitivity/specificity of 39.2%/93.3% ON and 22.5%/96.3% OFF.

Discussion

The MDS-UPDRS is a pragmatic clinical screen for anxiety, useful in triaging patients in need of comprehensive anxiety assessments. This study examines the screening performance of the MDS-UPDRS and provides a framework for how the scale can be operationalized in clinical settings to optimize identification of patients with clinically significant anxiety.