Depression and quality of life in monogenic compared to idiopathic, early‐onset Parkinson's disease

Abstract

Quality of life (QoL) is decreased in PD and is linked with depression and anxiety. However, little is known about QoL in monogenic PD. Subjects with mutations in PD genes were recruited from ongoing family and genetic studies (manifesting carriers, n = 23; nonmanifesting carriers, n = 19). For comparison purposes, we included patients with idiopathic PD (IPD; n = 128; early onset, n = 38; late onset, n = 90), healthy controls (n = 127), and data on depressive symptoms of 144 patients with major depression (treated controls). Depression affected 31% of early-onset PD cases, 21% of late-onset cases, and 44% of manifesting carriers of mutations in PD genes, but was rare in the nonmanifesting carriers (7%) and healthy controls (5%). Subjects with Parkinson-associated depression reported fewer feelings of guilt or self-doubt than treated controls, but the occurrence of suicidal ideation was associated with severity of depression only. Social phobia (P = 0.018) and agoraphobia (P = 0.059) were more common in manifesting carriers than in any other group. QoL was decreased in the Parkinson groups, particularly in the early-onset cases (P < 0.001), and QoL correlated with depression in all analyses. In our study, monogenic and IPD cases were comparable in QoL and depression characteristics. The QoL and, possibly, overall prognosis of all PD patients can be improved by appropriate attention and treatment for depression, sleep impairments, and anxiety, even if the treatment of the motor problems cannot be further optimized.

Anxiety and Depression in Patients with Parkinson's Disease

“…These studies did not include nonmotor symptoms as independent variables. A recent systematic review concluded that depression, disease severity and disability negatively influence the patient-reported impact of PD and thus determined depression to be an important predictor of QOL (36). Similar results have been reported for anxiety (3)(4)(5); however, with insufficient supporting data (37).…”

A systematic review of the literature on disorders of sleep and wakefulness in Parkinson's disease from 2005 to 2015

“…Insomnia has a significant negative impact on QOL in PD [3,210-213,213,214]; at least 10% of patients with advanced PD rank sleep problems as their most bothersome symptom[185]. …”

Cognitive behavioral therapy for insomnia in Parkinson’s disease: a case series

“…1, 3 Insomnia significantly negatively impacts quality of life in PD. 4–9 Thus, effective and safe therapies for it are essential. Evidence supporting the use of hypnotics for treatment of chronic insomnia in PD is limited, and there are significant concerns for side effects, particularly increased fall risk.…”