Depression in Parkinson's disease.
OBJECTIVE
To examine predictive factors associated with onset of depression among individuals diagnosed with Parkinson's disease (PD).


BACKGROUND
Depression may precede or follow symptomatic parkinsonism in PD. It is frequently treatable but often overlooked.


METHODS
The clinical series comprised 685 individuals who were diagnosed with PD and followed by one neurologist (RJU) from 1994 to 2007. The primary outcome was time to depression following the onset of PD. Diagnosis of depression was based on clinical assessment of depressive symptoms from patients (and spouse/family/caregiver) and antidepressant usage. A number of demographic, historical and clinical predictive factors were examined, including gender, age at symptomatic onset, disease duration, onset characteristics, clinical ratings, antiparkinsonian medications, cognitive status, depression history, and familial history of PD and other neurodegenerative disorders.


RESULTS
Seventy-two percent of patients developed depression within ten years of symptomatic PD onset, and the mean time to depression was 7.9 years (median: 5.7 years). Factors associated with depression included longer PD duration, greater impairment in activities of daily living, and positive family history of motor neuron disease (MND).


CONCLUSIONS
A high rate of individuals with PD develop depressive symptoms during the course of the disease. Based on first clinic visit characteristics, most factors examined were not helpful in identifying individuals with an increased risk of depression. However, disease duration, functional limitations and family history of MND should lead clinicians to an increased vigilance for identifying depression.
Jasinska-Myga
Barbara
B
Department of Neurology, Mayo Clinic, Jacksonville, Florida 32224, USA.
Putzke
John D
JD
Wider
Christian
C
Wszolek
Zbigniew K
ZK
Uitti
Ryan J
RJ
D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003863:Depression / Q000150:complications* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000523:psychology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis
D000978:Antiparkinson Agents