Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease: A Meta-Analysis of Mood Effects.

This meta-analysis examines mood changes after bilateral subthalamic deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD). Deep brain stimulation improves motor outcomes in Parkinson's disease but there appears to be conflicting reports as to subsequent mood outcomes. Pubmed, PsychINFO and SCOPUS were searched for studies assessing mood outcomes in PD patients who had undergone STN-DBS published between January 2003 and the end of January 2019. Random effects meta-analyses were conducted for all outcome groups with at least two studies homogenous in design and measure. Forty-eight studies, providing data on negative moods (such as depression, anxiety, apathy, and anger) and positive moods (pleasure and euphoria) were assessed. Results of the meta-analysis suggest that post-DBS, depression and anxiety symptoms improve and there is a reduction in negative affect, an increase in apathy, and in energy level. Although there have been reported cases of mania post-DBS surgery, the meta-analysis suggested no significant changes in symptoms of mania in the broader DBS population. Considerable heterogeneity was found and partially addressed through meta-regression and qualitative assessment of the included STN-DBS controlled studies. The major strengths of this meta-analysis, include attention to outcome validity, heterogeneity, independence of samples, and clinical utility, with the potential to improve post-operative safety through comprehensive consideration of mood and psychological adjustment. It appears that STN-DBS is a relatively safe and, in the case of mood symptomatology, an advantageous treatment of Parkinson's disease.

The Role of Anxiety and Dissociation in Young Australian Gamblers.

The aim of the present study was to examine predictors of 'escape style' problem gambling among young Australian gamblers. Anxiety and dissociation are considered to be predictors of 'escape style' gambling behaviour although this assessment has neglected consideration of different modes of gambling. This study builds on existing research, to examine the role of anxiety and dissociation in the gambling habits of young Australian male and female gamblers. One hundred and forty-two participants aged between 18 and 35 years self-selected and completed an online questionnaire. The hypothesis that gamblers would have similar levels of dissociation and anxiety despite different modes of gambling was supported. The hypothesis that anxiety and dissociation would both together and uniquely predict problem gambling behaviour across a range of gambling modalities was supported. Further, the hypothesis that there would be an interaction effect between anxiety and dissociation such that their presence together would predict a higher degree of problem gambling behaviour was supported. Results suggest that anxiety and dissociation play an important role in 'escape style' gambling and that strategies to combat problem gambling may benefit from research targeting anxiety and attempting to rechannel dissociative behaviour into healthier pursuits.