Mental health care use in Parkinson's disease: a record linkage study.
OBJECTIVE
Parkinson's disease (PD) is often complicated by psychiatric comorbidity, which is likely to lead to a higher use of mental health care facilities. In addition, psychiatric symptomatology and associated mental health care use may be present even before motor symptoms and PD are diagnosed, as the pathophysiology of PD and its psychiatric consequences are likely to overlap to a degree. This will be reflected in an increasing mental health care use prior to the diagnosis of PD. The aim of this study is to compare the level of mental health care use of PD patients with that of a matched control population, and to assess possible fluctuations in mental health care use in the years surrounding the diagnosis of PD.


METHODS
Record linkage study comparing the number of mental health care contacts by PD patients with that of a matched control population.


RESULTS
Mental health care use by PD patients already increased before the time of diagnosis of PD, and decreased again after diagnosis. The relative risk for mental health care use was increased from 3 years prior (RR 1.41; 95% CI 1.27-1.57) to 2 years after (RR 1.83; 95% CI 1.63-2.05) diagnosing PD. This increase was higher for women than for men, and higher for younger than older individuals.


CONCLUSIONS
The early pathophysiology of PD is expressed in part as mental health problems, suggesting the possibility of early detection in particular demographic groups and a proactive approach to early intervention for comorbid psychopathology.
Leentjens
A F G
AF
Department of Psychiatry, Maastricht University Hospital, Maastricht, The Netherlands. a.leentjens@np.unimaas.nl
Driessen
G
G
Weber
W
W
Drukker
M
M
van Os
J
J
D000367:Age Factors; D016022:Case-Control Studies; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010300:Parkinson Disease / Q000453:epidemiology* / Q000523:psychology*; D012306:Risk; D012737:Sex Factors