Validation of the Distress Thermometer as a Screening Tool for Psychosocial Distress and Resilience in Parkinson's Disease

Abstract

AbstractBackgroundParkinson's disease (PD) is associated with psychosocial distress that affects patients’ quality of life. The distress thermometer (DT) is an 11‐point visual analogue scale that is used as a screening tool for the assessment of psychosocial distress, originally developed for oncological diseases.ObjectivesTo validate the DT for PD and to explore contributing factors.MethodsThe DT scale was administered to 105 people with Parkinson's Disease (PwPD). Along with it, we assessed motor symptoms (Unified Parkinson's Disease Rating Scale part III [UPDRS III], Hoehn and Yahr‐stage [H&Y]), non‐motor symptoms (Non‐motor Symptom Questionnaire [NMSQ]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS], Fear of Progression‐Questionnaire Short Form [FOP‐Q‐SF], Generalized Anxiety Disorder Scale‐7 [GAD‐7], 9‐question Patient Health Questionnaire [PHQ‐9]), the feeling of hope (Herth Hope Index [HHI]) and quality of life (Schedule for the Evaluation of Individual Quality of Life [SEIQoL]).ResultsWith a cut‐off of 4, the DT identified PwPD with distress with a sensitivity of 97% and a specificity of 38%. With this cut‐off, the DT will yield false negative results in 1 out of 100 cases. Factor analyses and a random forest regression of the dataset revealed that distress can be predicted by two factors, which we termed “anxiety” and “depression/resilience/motor symptoms”.ConclusionThe DT is an ultra‐short and reliable screening tool for distress in PwPD. DT values below 4 rule out distress with a high degree of certainty. Anxiety and depression are important factors in distress but are counterbalanced by the individuals’ psychological resilience.