Risk Factors for Depression in Parkinson Disease

Tandberg, Elise; Larsen, Jan Petter; Aarsland, Dag; Laake, Knut; Cummings, Jeffrey L.

doi:10.1001/archneur.1997.00550170097020

Cited by 177 publications

(126 citation statements)

References 27 publications

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“…We found that although these two variables were associated with depression in univariate analyses, in the multivariate logistic regression model they were only associated with the occurrence of co-morbid psychosis and depression. If true, this suggests that previous research reporting an association between depression and both greater cognitive impairment [9] and higher levodopa doses [11] may have been confounded by the cooccurrence of psychotic symptoms. It also under-scores the importance of accounting for psychiatric and cognitive co-morbidity when determining the correlates of psychiatric disorders in PD.…”

Section: Discussionmentioning

confidence: 96%

“…If so, this may be due to common risk factors, including increasing age [6,8], greater cognitive impairment [4,9], and greater PD severity [6,9]. Other purported risk factors for individual disorders include exposure to most dopaminergic therapies (psychosis) [10], and female sex, predominantly right-sided motor symptoms, and treatment with higher levodopa doses (depression) [9,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Frequency and correlates of co-morbid psychosis and depression in Parkinson's disease

Weintraub¹,

Morales²,

Duda³

et al. 2006

Parkinsonism & Related Disorders

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Though both psychosis and depression are common in Parkinson's disease (PD), it is not clear if an association between the two disorders exists. One hundred and thirty PD patients were divided into four groups based on a comprehensive psychiatric assessment: (1) no depression or psychosis (47.7%); (2) psychosis only (16.2%); (3) depression only (26.2%); and (4) psychosis and depression (10.0%). Co-morbid psychosis and depression did not occur more frequently than expected by chance (P = .77). Psychosis was associated with dopamine agonist use (P = .02), depression with mildcognitive impairment (P = .03), and their co-occurrence with higher daily levodopa dosages (P<.01). These results suggest that psychosis and depression in PD are distinct neurobehavioral disorders.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Frequency and correlates of co-morbid psychosis and depression in Parkinson's disease

Weintraub¹,

Morales²,

Duda³

et al. 2006

Parkinsonism & Related Disorders

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“…If there was a bias in sample selection, with a predominance of patients presenting with the rigid-akinetic form of pd or with motor complications, the study could be more prone to detect an association between motor signs and depression. In view of our current knowledge about depression in pd, it would be more suitable to regard it as a complex and multifactorial problem that also includes situational and psychological factors taking part in the mechanisms that can elicit mood changes in the patients 30 . Appropriate studies are needed to address this controversial matter.…”

Section: Discussionmentioning

confidence: 99%

The accuracy of diagnosis of major depression in patients with Parkinson's disease: a comparative study among the UPDRS, the geriatric depression scale and the Beck depression inventory

Tumas

Rodrigues

Farias

et al. 2008

Arq. Neuro-Psiquiatr.

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-Objective: Evaluate the accuracy of diagnosis of major depression in patients with parkinson's disease (pd) using the updrs, the 15-item Geriatric depression scale (Gds15) and the Beck depression Inventory (BdI). Method: 50 consecutive patients with pd were evaluated. The diagnosis of major depression was made according to the dsM-IV criteria. Results: We found a 24% prevalence of major depression. All depression scales were highly correlated but updrs depression item had the lowest diagnostic value. The Gds15 had the more appropriate "receiver operating characteristics" curve. The best cut-off scores for screening depression were 17/18 for BdI and 8/9 for Gds15. We did not find any correlation between the level of depression and intensity of motor symptoms, functional capacity and duration of the disease. Conclusion: Gds15 is better than the BdI and the updrs for screening depression in pd and depression is not related to the degree of parkinsonian symptoms.KEY WOrds: depression, parkinson's disease, updrs, Beck depression Inventory, Geriatric depression scale. A precisão do diagnóstico de depressão na doença de Parkinson: um estudo comparativo entre a UPDRS, a Escala Geriátrica de Depressão e o Inventário de Depressão de BeckResumo -Objetivo: Avaliar a precisão do diagnóstico de depressão em pacientes com doença de parkinson avaliados pela updrs, pela Escala Geriátrica de depressão com 15 itens (EGd15) e pelo Inventário de depressão de Beck (IdB). Método: 50 pacientes com dp foram avaliados. O diagnóstico de depressão maior foi feito segundo os critérios do dsM-IV. Resultados: A prevalência de depressão foi 24%. As escalas de depressão tiveram elevada correlação entre si. A updrs apresentou a menor sensibilidade para o diagnóstico. A EGd15 mostrou uma curva rOC mais apropriada que o IdB. Os melhores escores-de-corte para diagnóstico de depressão foram 17/18 para o IdB e 8/9 para a EGd15. Não houve correlação entre os níveis de depressão e a intensidade do parkinsonismo, a capacidade funcional ou a duração da doença. Conclusão: A EGd15 é melhor que o IdB para diagnosticar depressão na dp. A depressão não está relacionada à gravidade dos sintomas parkinsonianos. depression is a frequent co-morbidity affecting around 20% to 40% of patients with parkinson's disease (pd) 1 . Moreover, depression is also pointed as one of the most important factors impairing the quality of life of patients and their caregivers 2,3 . despite its clinical significance, depression still remains as an underdiagnosed problem in patients with pd 4 .One reason for that may be the little attention given for this problem during the clinical evaluation. The unified parkinson's disease rating scale (updrs) dedicates only one item to evaluate depression 5 . The clinician rates his clinical impression after a free medical interview and grades depression subjectively at 4 levels of severity. To our knowledge, the reliability and validity of the updrs

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“…Early-onset PD may be a risk factor for depression [27] while research regarding the relationship between PD severity and depression has yielded mixed results [27,28,29]. Depression in PD (dPD) may precede the onset of motor symptoms [30], is often under-detected by medical professionals [31], and warrants significant attention from clinicians as it is related to a faster progression of physical symptoms, greater cognitive decline, poorer quality of life, increased caregiver burden, and decreased ability to care for oneself [32,33,34,35,36].…”

Section: Depression and Parkinson's Diseasementioning

confidence: 99%

CBT for the treatment of depression in Parkinson’s disease: a promising nonpharmacological approach

Dobkin¹,

Menza²,

Bienfait³

2008

Expert Review of Neurotherapeutics

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Depression is very common in PD and linked with a faster progression of physical symptoms, greater cognitive decline, and poorer quality of life. Non-pharmacological approaches, like cognitivebehavioral therapy (CBT), for the treatment of depression in Parkinson's disease (dPD) have received little experimental attention despite strong demonstrated efficacy in other geriatric and medical populations. Depressed PD patients often differ from the depressed non-PD elderly in that they present with increased rates of both executive dysfunction and co-morbid psychiatric diagnoses, may differ in their depressive symptom presentation, and typically have caregivers who are highly involved in their treatment. Therefore, it is not possible to conclude that empirically validated treatments in the depressed aged will generalize to those with Parkinson's disease. In order to be most effective for PD patients, CBT should be tailored to their unique needs. Additional controlled research is needed to further explore the efficacy of CBT for dPD.

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Risk Factors for Depression in Parkinson Disease

Abstract: Most of the observations of this study favor the hypothesis that depression in PD is a primary consequence of brain dysfunction. Situational factors may, however, also contribute to mood changes in PD.

Cited by 177 publications

References 27 publications

Frequency and correlates of co-morbid psychosis and depression in Parkinson's disease

Frequency and correlates of co-morbid psychosis and depression in Parkinson's disease

The accuracy of diagnosis of major depression in patients with Parkinson's disease: a comparative study among the UPDRS, the geriatric depression scale and the Beck depression inventory

CBT for the treatment of depression in Parkinson’s disease: a promising nonpharmacological approach

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