Parkinson’s disease is frequently associated with depressive symptoms. When depression occurs at early stages and before the onset of characteristic motor symptoms of the disease, differential diagnosis of major depression may be difficult. Differences in psychopathological features of depression in Parkinson’s disease and major depression have been reported by some authors. This study presents data of 49 patients with depression in Parkinson’s disease and 38 patients with major depression. The severity of depressive symptoms was equivalent in both groups. Depressive features did not differ between the two groups with exception of affective flattening, delusional ideas and suicide attempts. In conclusion, this investigation gives support to the assumption of a common neurobiological origin of depression in Parkinson’s disease and major depression.

A growing body of data suggests that there are important differences in the distribution of occlusive vascular disease in blacks and whites and in men and women" (Stroke 1986;17:648-655).Caplan amplified on this report at an American Heart Association program in Monterey, Calif. He classified people with strokes into three groups, based on the blood vessel, and therefore the brain region, affected. He added a fourth group that he and colleagues suggest provides data in support of their hypothesis.The first group, of which two thirds are men, has blockage or narrowing of the internal carotid and vertebral arteries, secondary to atherosclerosis. These patients also have a high incidence of coronary artery disease.In the second group, lacunar infarcts occur in the brain's deep white matter. The small arteries that supply these re¬ gions are constricted by muscular pro¬ liferation due to hypertension. These patients also have a high incidence of diabetes.The third group has occlusion of the medium-sized arteries that branch within the skull, such as the middle, anterior, and posterior cerebral ar¬ teries. A thrombus from the heart or proximal arterial system in the neck breaks loose and obstructs the vessel.These patients also have a high inci¬ dence of coronary artery disease and atherosclerosis.This schema was developed from studies primarily of white patients.When a group of both black and white patients was studied by Caplan and colleagues (Stroke 1985;16:785-790) and by investigators from the National In¬ stitute of Neurological and Communica¬ tive Disorders and Stroke, Bethesda, Md, a fourth group of patients that differed in race and gender from the other three groups was identified.These patients, primarily black wom¬ en, have narrowing of large arteries in the skull, a low incidence of coronary artery disease, and a high incidence of hypertension and diabetes. This pat¬ tern is also found in Orientals, in women using oral contraceptives, and in preg¬ nant women who experience strokes.

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