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Depression in Parkinson's Disease

Published online by Cambridge University Press:  02 December 2014

Barbara Jasinska-Myga ,
John D. Putzke ,
Christian Wider ,
Zbigniew K. Wszolek  and
Ryan J. Uitti
Barbara Jasinska-Myga
Affiliation:
Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA Department of Neurology, Aging, Degenerative and Cerebrovascular Disorders, Medical University of Silesia, Katowice, Poland
John D. Putzke
Affiliation:
Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
Christian Wider
Affiliation:
Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
Zbigniew K. Wszolek
Affiliation:
Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
Ryan J. Uitti*
Affiliation:
Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
*
Department of Neurology, Cannaday Building 2E, Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, Florida, 32224, USA.
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Abstract

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Objective:

To examine predictive factors associated with onset of depression among individuals diagnosed with Parkinson's disease (PD).

Background:

Depression may precede or follow symptomatic parkinsonism in PD. It is frequently treatable but often overlooked.

Methods:

The clinical series comprised 685 individuals who were diagnosed with PD and followed by one neurologist (RJU) from 1994 to 2007. The primary outcome was time to depression following the onset of PD. Diagnosis of depression was based on clinical assessment of depressive symptoms from patients (and spouse/family/caregiver) and antidepressant usage. A number of demographic, historical and clinical predictive factors were examined, including gender, age at symptomatic onset, disease duration, onset characteristics, clinical ratings, antiparkinsonian medications, cognitive status, depression history, and familial history of PD and other neurodegenerative disorders.

Results:

Seventy-two percent of patients developed depression within ten years of symptomatic PD onset, and the mean time to depression was 7.9 years (median: 5.7 years). Factors associated with depression included longer PD duration, greater impairment in activities of daily living, and positive family history of motor neuron disease (MND).

Conclusions:

A high rate of individuals with PD develop depressive symptoms during the course of the disease. Based on first clinic visit characteristics, most factors examined were not helpful in identifying individuals with an increased risk of depression. However, disease duration, functional limitations and family history of MND should lead clinicians to an increased vigilance for identifying depression.

Objectif:

Le but de l’étude était d’examiner les facteurs de prédisposition pour la dépression chez les patients atteints de la maladie de Parkinson (MP).

Contexte:

La dépression peut précéder les symptômes de la MP ou apparaître au cours de l’évolution de la maladie. Il s’agit d’un problème traitable mais souvent ignoré.

Méthodes:

Nous avons étudié 685 individus, suivis par le même neurologue (RJU) entre 1994 et 2007, chez qui un diagnostic de MP avait été posé. L’issue primaire était le temps écoulé entre le début de la MP et l’installation de la dépression. Le diagnostic de dépression était basé sur l’évaluation clinique des symptômes dépressifs décrits par les patients (et l’épouse/la famille/le soignant) et la prise d’antidépresseurs. Certains facteurs démographiques, historiques et cliniques de prédisposition ont été examinés, dont le sexe, l’âge au moment du début des symptômes, la durée de la maladie, les manifestations au début de la maladie, les évaluations cliniques, la médication antiparkinsonienne, l’état cognitif, l’histoire antérieure de dépression et l’histoire familiale de MP ainsi que d’autres maladies neurodégénératives.

Résultats:

Soixante-douze pour cent des patients ont présenté une dépression au cours des dix années qui ont suivi le début des symptômes de la MP et le temps moyen écoulé depuis le début de la maladie était de 7,9 ans (médiane 5,7 ans). Les facteurs associés à la dépression étaient une durée d’évolution plus longue de la MP, un impact plus important sur les activités de la vie quotidienne et une histoire familiale positive de maladie du neurone moteur (MNM).

Conclusions:

Une proportion élevée de patients atteints de la MP éprouvent des symptômes de dépression au cours de la maladie. La plupart des facteurs examinés, parmi les observations notées à la première visite à la clinique, n’aidaient pas à identifier les individus à plus haut risque de dépression. Cependant, la durée de la maladie, les limites fonctionnelles et une histoire familiale de MNM devraient inciter les cliniciens à exercer plus de vigilance en ce qui concerne la dépression.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 1 , January 2010 , pp. 61 - 66
Copyright
Copyright © The Canadian Journal of Neurological 2010

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