Depression in Parkinson's disease: conceptual issues and clinical challenges.
BACKGROUND
Depression frequently accompanies Parkinson's disease (PD) and may have a negative impact on activities of daily living, cognitive performance, and quality of life. Because of the symptom overlap between the 2 disorders, it may be difficult to recognize depression in PD. Moreover, the partially shared pathophysiology may make it difficult to treat depressive symptoms without influencing motor or cognitive function.


OBJECTIVE
To review the current knowledge of the epidemiology, etiology, pathophysiology, and treatment of depression in patients with Parkinson's disease.


METHODS
Discussion of recent studies and relevant literature.


CONCLUSIONS
Not only conceptually but also in terms of etiology, pathophysiology, and treatment, the relationship between PD and depression remains a challenge. There are still many questions to be answered. In the therapeutic domain, large, placebo-controlled trials are necessary to evaluate the efficacy of antidepressant treatment and allow the development of evidence-based guidelines.
Leentjens
Albert F G
AF
Department of Psychiatry, Maastricht University Hospital, PO Box 5800, 6202 AZ, the Netherlands. a.leentjens@np.unimaas.nl
D000203:Activities of Daily Living; D003863:Depression / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D019317:Evidence-Based Medicine; D006801:Humans; D015994:Incidence; D010300:Parkinson Disease / Q000150:complications* / Q000523:psychology*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic