{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:28:44Z","timestamp":1791602924169,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009152","name":"Fondation Bertarelli","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009152","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Shame is frequent in Parkinson's disease (PD) and often overlooked.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim was to assess factors associated with PD\u2010related shame.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PD\u2010related shame was measured using the Shame and Embarrassment in PD (SPARK) scale in patients without cognitive impairment. Correlation between\n                      <jats:italic>personal determinants<\/jats:italic>\n                      (demographics, psychological traits [shame\/guilt propensity, trait anxiety]),\n                      <jats:italic>PD\u2010related determinants<\/jats:italic>\n                      (PD characteristics; motor, cognitive, and neuropsychiatric symptoms; medication; and health\u2010related quality of life [QoL]), and SPARK was analyzed using multiple correlation analysis and generalized linear mixed models. To describe the cohort's response to shame, data\u2010driven clustering based on SPARK was conducted, and clusters' associations with the determinants were analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010seven PD patients were included. PD\u2010related shame correlated with\n                      <jats:italic>psychological traits<\/jats:italic>\n                      (trait anxiety, shame, and guilt propensity),\n                      <jats:italic>clinical symptoms<\/jats:italic>\n                      (dyskinesia, state anxiety, depression, and apathy), and\n                      <jats:italic>QoL<\/jats:italic>\n                      . These determinants explained 79.3% of the total variance in the subsequent linear model analysis, with QoL and anxiety as the strongest covariates of shame. Apathy positively covaried with SPARK self\u2010esteem subscale. Cluster analysis identified 3 patient groups. Highest\u2010intensity shame cluster demonstrated elevated scores on both motor and nonmotor symptom\u2013related shame and was associated with higher levels in anxiety, depression, and apathy, and poorer QoL. The remaining clusters showed a dissociation, with motor symptom\u2013related shame predominating in one and nonmotor symptom\u2013related shame in the other.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides an in\u2010depth understanding of shame, highlighting its multifactorial nature. Due to its impact on QoL, shame should be addressed in clinical practice through pharmacological\/nonpharmacological interventions, targeting both shame and its modifiable determinants. Identifying distinct shame profiles underscores the need for tailored interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70128","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T04:33:43Z","timestamp":1747629223000},"page":"1551-1559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Unseen Burden: Uncovering Shame and Its Determinants in Parkinson's Disease"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3789-5827","authenticated-orcid":false,"given":"Sabina","family":"Catalano Chiuv\u00e9","sequence":"first","affiliation":[{"name":"Department of Neurology Geneva University Hospital  Geneva 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