What determines resilience in patients with Parkinson's disease?

Objective: To investigate the relationship of resilience to disease severity, disability, quality of life (QoL) and non-motor symptoms in Parkinson's disease (PD). A secondary objective was to investigate whether resilience is distinct from other personality domains in PD. Background: Resilience is the ability to reestablish emotional equilibrium in the face of adversity. It may play a pivotal role in disability and quality of life and has not been studied in PD. Methods: 83 PD patients (Age 66.3 +/- 10.6, Total Unified Parkinson's Disease Rating Scale (T-UPDRS) 36.9 +/- 17.8) completed the Resilience Scale 15 (RS-15). Scales measuring disability, mental and physical health-related QoL, non-motor symptoms (depression, anxiety, somatization, apathy, fatigue), and personality domains were completed. Pearson's correlations were analyzed between these scales and the RS-15. Results: Greater resilience correlated with less disability (r = -.30, p = .01), and better physical and mental QoL (r = .31, p < .01; r = .29, p = .01), but not with PD severity (T-UPDRS, r = -.17, p > .05). Among non-motor symptoms and personality domains, resilience strongly correlated with less apathy (r = -.66), less depression (r = -.49), and more optimism (r = .54, all p < .001). Moderate correlations were seen between more resilience, reduced fatigue (r = -.40) and anxiety (r = -.34; both p < .001). Conclusions: Resilience correlated with less disability and better QoL but not with PD severity. Resilience was also highly associated with both non-motor symptoms (less apathy, depression, fatigue) and a personality domain (more optimism). The role of resilience in helping patients adapt to living with symptoms of chronic disease may explain its lack of correlation with PD severity. (C) 2011 Elsevier Ltd. All rights reserved.