Patients With Parkinson Disease Are at High Risk for Depression

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Depression is a common and progressive disease in patients with Parkinson's.
Depression is a common and progressive disease in patients with Parkinson's.

Depression is a frequent and progressive condition among patients with Parkinson disease (PD), according to study findings presented in the Journal of Neurology.

Investigators sought to determine the frequency of depressive symptoms among drug-naive patients with PD (n=187) vs controls (n=166) based on patient data from the longitudinal, population-based Norwegian ParkWest study. The researchers used the Montgomery and Aasberg Depression Rating Scale to identify depression at diagnosis as well as at 7 years.

Average depression scores were lower among controls vs patients with PD (1.3 vs 4.2, respectively). Rates of depression and depressive symptoms were also lower than in patients with PD during the follow-up periods.

Antidepressant use was higher in PD compared with controls at baseline (12% vs 2%, respectively), with the rates remaining fairly consistent at follow-up. The investigators also found an association between higher depression scores and female sex, dependency, high pain scores, and lower Mini-Mental State Examination scores.

These findings not only indicate the higher prevalence of depression among patients with PD but also demonstrate the potential for risk stratification among patients with nonspecific PD characteristics, such as female sex and higher levels of perceived pain.

According to the investigators, the use of a depression rating scale rather than diagnostic interviews to identify the type and severity of disturbances in PD potentially limited the findings.

Considering that depression "is correlated with poor quality of life...and increased caregiver burden" in patients with PD, the investigators suggest longer-term cohort studies on this topic as a means to expand current understanding of depression in more advanced PD.

Reference

Larsen JP, Dalen I, Pedersen KF, Tysnes OB. The natural history of depressive symptoms in patients with incident Parkinson's disease: a prospective cohort study [published online October 14, 2017]. J Neurol. doi: 10.1007/s00415-017-8638-1

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