title: Impact of pre-morbid depression on health-related quality of life in non-demented Parkinson's disease patients.
abstract: The need to understand and improve health-related quality of life (Hr-QoL) in Parkinson's disease (PD) has been emphasized. In order to investigate contributions of depression that existed before the onset of typical motor symptoms ("pre-PD depression"), idiopathic non-demented non-psychotic patients with (n = 32) and without (n = 120) a history of pre-PD depression, free of relevant comorbidity, calliper-matched for age, education and disease duration were evaluated for motor and non-motor disease aspects and Hr-QoL (Parkinson's Disease Questionnaire 39, PDQ-39). History of pre-PD depression was independently associated with higher actual levels of depression and anxiety, poorer sleep quality and mental set shifting, which all contributed to poorer Hr-QoL. Mediation analysis demonstrated significant indirect effects (mediated through the effects on mood/emotion/sleep and/or cognition) of pre-PD depression on PDQ summary index and subscales, but also direct (non-mediated) effects on emotional well-being and body discomfort subscales independent of the sociodemographic, motor/non-motor disease or treatment-related characteristics. Data indicate that for a given level of motor/non-motor PD symptoms severity, history of pre-PD depression contributes to poorer Hr-QoL.
authors.affiliation: Department of Neurology, University Hospital Centre Zagreb, Zagreb University School of Medicine, Kispatićeva 12, Zagreb, Croatia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Klepac
authors.forename: Sanja
authors.initials: S
authors.lastname: Hajnsek
authors.forename: Vladimir
authors.initials: V
authors.lastname: Trkulja
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009017:Morbidity; D010300:Parkinson Disease / Q000150:complications / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires