Background: Shame is frequent in Parkinson’s disease (PD) and often overlooked.

Objective: TheaimwastoassessfactorsassociatedwithPD-relatedshame.

Methods: PD-relatedshamewasmeasuredusingtheShameandEmbarrassmentinPD(SPARK)scaleinpatients without cognitive impairment. Correlation between personal determinants (demographics, psychological traits [shame/guilt propensity, trait anxiety]), PD-related determinants (PD characteristics; motor, cognitive, and neuropsychiatric symptoms; medication; and health-related 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- driven clustering based on SPARK was conducted, and clusters’ associations with the determinants were analyzed.

Results: Forty-sevenPDpatientswereincluded.PD-relatedshamecorrelatedwithpsychologicaltraits(trait anxiety, shame, and guilt propensity), clinical symptoms (dyskinesia, state anxiety, depression, and apathy), and QoL. 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-esteem subscale. Cluster analysis identified 3 patient groups. Highest-intensity shame cluster demonstrated elevated scores on both motor and nonmotor symptom–related shame and was associated with higher levels in anxiety, depression, and apathy, and poorer QoL. The remaining clusters showed a dissociation, with motor symptom– related shame predominating in one and nonmotor symptom–related shame in the other.

Conclusions: Thisstudyprovidesanin-depthunderstandingofshame,highlightingitsmultifactorialnature.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.