HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 01.wnl.0000268695.63392.10v1 69/4/342    most recent Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ravina, B. Articles by Elm, J. Search for Related Content PubMed PubMed Citation Articles by Ravina, B. Articles by Elm, J. Related Collections Parkinson's disease/Parkinsonism Depression

The impact of depressive symptoms in early Parkinson disease

From the Department of Neurology (B.R., P.G.C.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology (R.C.), University of Alberta, Edmonton, Canada; Departments of Psychiatry and Neurology (L.M.), Johns Hopkins University, Baltimore, MD; Department of Neurology (J.J.), Baylor University, Houston, TX; Departments of Psychiatry and Neurology (D.W.), University of Pennsylvania, Philadelphia; and Department of Biostatistics (J.E.), Medical University of South Carolina, Charleston.

Address correspondence and reprint requests to Dr. Bernard Ravina, 1351 Mt. Hope Ave., Suite 223, Rochester, NY 14620 Bernard.ravina{at}ctcc.rochester.edu

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.

E-pub ahead of print at www.neurology.org.

Sponsored by the NIH (National Institute of Neurological Disorders and Stroke), U01NS043127 and U01NS043128.

Disclosure: The authors report no conflicts of interest.

Received January 15, 2007. Accepted in final form April 19, 2007.

This article has been cited by other articles:

				A Alonso, L A G. Rodriguez, G Logroscino, and M A Hernan Use of antidepressants and the risk of Parkinson's disease: a prospective study J. Neurol. Neurosurg. Psychiatry, June 1, 2009; 80(6): 671 - 674. [Abstract] [Full Text] [PDF]

				M. Menza, R. D. Dobkin, H. Marin, M. H. Mark, M. Gara, S. Buyske, K. Bienfait, and A. Dicke A controlled trial of antidepressants in patients with Parkinson disease and depression Neurology, March 10, 2009; 72(10): 886 - 892. [Abstract] [Full Text] [PDF]

				E. Tolosa, C. Gaig, J. Santamaria, and Y. Compta Diagnosis and the premotor phase of Parkinson disease Neurology, February 17, 2009; 72(7_Supplement_2): S12 - S20. [Abstract] [Full Text] [PDF]

				J Jankovic Parkinson's disease: clinical features and diagnosis J. Neurol. Neurosurg. Psychiatry, April 1, 2008; 79(4): 368 - 376. [Abstract] [Full Text] [PDF]

				S. Karceski Early Parkinson disease and depression Neurology, July 24, 2007; 69(4): E2 - E3. [Full Text] [PDF]