title: Depression comorbidity in spinocerebellar ataxia.
abstract: This is a description of the prevalence and profile of depressive symptoms in dominant spinocerebellar ataxia (SCA). Depressive symptoms were assessed in a convenience sample of 526 genetically confirmed and clinically affected patients (117 SCA1, 163 SCA2, 139 SCA3, and 107 SCA6) using the Patient Health Questionnaire (PHQ). In addition, depressive status according to the examiner and the use of antidepressants was recorded. Depression self-assessment was compared with an interview-based psychiatric assessment in a subset of 26 patients. Depression prevalence estimates were 17.1% according to the PHQ algorithm and 15.4% when assessed clinically. The sensitivity of clinical impression compared with PHQ classification was low (0.35), whereas diagnostic accuracy of PHQ compared with psychiatric interview in the subset was high. Antidepressants were used by 17.7% of patients and in >10% of patients without current clinically relevant depressive symptoms. Depression profile in SCA did not differ from a sample of patients with major depressive disorder except for the movement-related item. Neither depression prevalence nor use of antidepressants differed between genetic subtypes, with only sleep disturbance more common in SCA3. In a multivariate analysis, ataxia severity and female sex independently predicted depressive status in SCA. The PHQ algorithmic classification is appropriate for use in SCA but should stimulate further psychiatric evaluation if depression is indicated. Despite a higher risk for depression with more severe disease, the relation of depressive symptoms to SCA neurodegeneration remains to be shown.
authors: Department of Neurology, University Hospital of Bonn, Bonn, Germany. tanja.schmitz-huebsch@ukb.uni-bonn.de
authors: Tanja
authors: T
authors: Schmitz-Hübsch
authors: Mathieu
authors: M
authors: Coudert
authors: Sophie
authors: S
authors: Tezenas du Montcel
authors: Paola
authors: P
authors: Giunti
authors: Robyn
authors: R
authors: Labrum
authors: Alexandra
authors: A
authors: Dürr
authors: Pascale
authors: P
authors: Ribai
authors: Perrine
authors: P
authors: Charles
authors: Christoph
authors: C
authors: Linnemann
authors: Ludger
authors: L
authors: Schöls
authors: Maryla
authors: M
authors: Rakowicz
authors: Rafal
authors: R
authors: Rola
authors: Elszbieta
authors: E
authors: Zdzienicka
authors: Roberto
authors: R
authors: Fancellu
authors: Caterina
authors: C
authors: Mariotti
authors: Lazlo
authors: L
authors: Baliko
authors: Bela
authors: B
authors: Melegh
authors: Alessandro
authors: A
authors: Filla
authors: Elena
authors: E
authors: Salvatore
authors: Bart P C
authors: BP
authors: van de Warrenburg
authors: Sandra
authors: S
authors: Szymanski
authors: Jon
authors: J
authors: Infante
authors: Dagmar
authors: D
authors: Timmann
authors: Sylvia
authors: S
authors: Boesch
authors: Chantal
authors: C
authors: Depondt
authors: Jun-Suk
authors: JS
authors: Kang
authors: Jörg B
authors: JB
authors: Schulz
authors: Thomas
authors: T
authors: Klopstock
authors: Nicole
authors: N
authors: Lossnitzer
authors: Bernd
authors: B
authors: Löwe
authors: Caroline
authors: C
authors: Frick
authors: Daniela
authors: D
authors: Rottländer
authors: Thomas E
authors: TE
authors: Schlaepfer
authors: Thomas
authors: T
authors: Klockgether
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020754:Spinocerebellar Ataxias / Q000453:epidemiology* / Q000235:genetics
chemical_list: D000928:Antidepressive Agents