BACKGROUND: Depressive disorders may affect up to 50% of patients with Parkinson disease (PD) and are associated with increased disability and reduced quality of life. No previous study has systematically examined the impact of depressive symptoms in early, untreated PD. METHODS: We administered the 15-item Geriatric Depression Scale (GDS-15) as part of two NIH-sponsored phase II clinical trials in PD, enrolling 413 early, untreated PD subjects. We used linear mixed models to examine the relationship of depressive symptoms, measured by the GDS-15, with motor function and activities of daily living (ADLs), as measured by the Unified PD Rating Scale (UPDRS). A time-dependent Cox model was used to examine the effect of demographic and clinical outcome measures as predictors of investigator-determined time to need for symptomatic therapy for PD. RESULTS: A total of 114 (27.6%) subjects screened positive for depression during the average 14.6 months of follow-up. Forty percent of these subjects were neither treated with antidepressants nor referred for further psychiatric evaluation. Depression, as assessed by the GDS-15, was a significant predictor of more impairment in ADLs (p < 0.0001) and increased need for symptomatic therapy of PD (hazard ratio = 1.86; 95% CI 1.29, 2.68). CONCLUSIONS: Clinically important depressive symptoms are common in early Parkinson disease (PD), but are often not treated. Depressive symptoms are an important contributor to disability and the decision to start symptomatic therapy for motor-related impairment in early PD, highlighting the broad importance of identifying and treating depression in this population.
BACKGROUND:Depressive disorders may affect up to 50% of patients with Parkinson disease (PD) and are associated with increased disability and reduced quality of life. No previous study has systematically examined the impact of depressive symptoms in early, untreated PD. METHODS: We administered the 15-item Geriatric Depression Scale (GDS-15) as part of two NIH-sponsored phase II clinical trials in PD, enrolling 413 early, untreated PD subjects. We used linear mixed models to examine the relationship of depressive symptoms, measured by the GDS-15, with motor function and activities of daily living (ADLs), as measured by the Unified PD Rating Scale (UPDRS). A time-dependent Cox model was used to examine the effect of demographic and clinical outcome measures as predictors of investigator-determined time to need for symptomatic therapy for PD. RESULTS: A total of 114 (27.6%) subjects screened positive for depression during the average 14.6 months of follow-up. Forty percent of these subjects were neither treated with antidepressants nor referred for further psychiatric evaluation. Depression, as assessed by the GDS-15, was a significant predictor of more impairment in ADLs (p < 0.0001) and increased need for symptomatic therapy of PD (hazard ratio = 1.86; 95% CI 1.29, 2.68). CONCLUSIONS: Clinically important depressive symptoms are common in early Parkinson disease (PD), but are often not treated. Depressive symptoms are an important contributor to disability and the decision to start symptomatic therapy for motor-related impairment in early PD, highlighting the broad importance of identifying and treating depression in this population.
Authors: Spiridon Papapetropoulos; John Ellul; Andreas A Argyriou; Elisabeth Chroni; Nicoletta P Lekka Journal: Clin Neurol Neurosurg Date: 2005-09-16 Impact factor: 1.876
Authors: Jeffrey M Lyness; Moonseong Heo; Catherine J Datto; Thomas R Ten Have; Ira R Katz; Rebecca Drayer; Charles F Reynolds; George S Alexopoulos; Martha L Bruce Journal: Ann Intern Med Date: 2006-04-04 Impact factor: 25.391
Authors: W Kuhn; N Heye; T Müller; P Kraus; P Klotz; B Friedrich; F L Welter; H Przuntek Journal: J Neural Transm (Vienna) Date: 1996 Impact factor: 3.575
Authors: Roseanne D Dobkin; Jade Tiu Rubino; Lesley A Allen; Jill Friedman; Michael A Gara; Margery H Mark; Matthew Menza Journal: J Consult Clin Psychol Date: 2012-03-12
Authors: Roseanne D Dobkin; Alexander I Tröster; Jade Tiu Rubino; Lesley A Allen; Michael A Gara; Margery H Mark; Matthew Menza Journal: J Neuropsychiatry Clin Neurosci Date: 2014 Impact factor: 2.198
Authors: J R Williams; E S Hirsch; K Anderson; A L Bush; S R Goldstein; S Grill; S Lehmann; J T Little; R L Margolis; J Palanci; G Pontone; H Weiss; P Rabins; L Marsh Journal: Neurology Date: 2012-03-14 Impact factor: 9.910
Authors: Roseanne D Dobkin; Jade Tiu Rubino; Jill Friedman; Lesley A Allen; Michael A Gara; Matthew Menza Journal: J Geriatr Psychiatry Neurol Date: 2013-04-15 Impact factor: 2.680
Authors: Alexandre Paim Diaz; Fernando Cini Freitas; Maria Emília de Oliveira Thais; Fernando Zanela da Silva Areas; Marcelo Liborio Schwarzbold; Rodrigo Debona; Jean Costa Nunes; Ricardo Guarnieri; Daniel Martinez-Ramirez; Rui Daniel Prediger; Aparna Wagle Shukla; Marcelo Neves Linhares; Roger Walz Journal: Neurol Sci Date: 2016-07-25 Impact factor: 3.307