title: Depression and quality of life in monogenic compared to idiopathic, early-onset Parkinson's disease.
abstract: Quality of life (QoL) is decreased in PD and is linked with depression and anxiety. However, little is known about QoL in monogenic PD. Subjects with mutations in PD genes were recruited from ongoing family and genetic studies (manifesting carriers, n = 23; nonmanifesting carriers, n = 19). For comparison purposes, we included patients with idiopathic PD (IPD; n = 128; early onset, n = 38; late onset, n = 90), healthy controls (n = 127), and data on depressive symptoms of 144 patients with major depression (treated controls). Depression affected 31% of early-onset PD cases, 21% of late-onset cases, and 44% of manifesting carriers of mutations in PD genes, but was rare in the nonmanifesting carriers (7%) and healthy controls (5%). Subjects with Parkinson-associated depression reported fewer feelings of guilt or self-doubt than treated controls, but the occurrence of suicidal ideation was associated with severity of depression only. Social phobia (P = 0.018) and agoraphobia (P = 0.059) were more common in manifesting carriers than in any other group. QoL was decreased in the Parkinson groups, particularly in the early-onset cases (P < 0.001), and QoL correlated with depression in all analyses. In our study, monogenic and IPD cases were comparable in QoL and depression characteristics. The QoL and, possibly, overall prognosis of all PD patients can be improved by appropriate attention and treatment for depression, sleep impairments, and anxiety, even if the treatment of the motor problems cannot be further optimized.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany. Meike.Kasten@neuro.uni-luebeck.de
authors.forename: Meike
authors.initials: M
authors.lastname: Kasten
authors.forename: Lena
authors.initials: L
authors.lastname: Kertelge
authors.forename: Vera
authors.initials: V
authors.lastname: Tadic
authors.forename: Norbert
authors.initials: N
authors.lastname: Brüggemann
authors.forename: Alexander
authors.initials: A
authors.lastname: Schmidt
authors.forename: Joyce
authors.initials: J
authors.lastname: van der Vegt
authors.forename: Hartwig
authors.initials: H
authors.lastname: Siebner
authors.forename: Carsten
authors.initials: C
authors.lastname: Buhmann
authors.forename: Rebekka
authors.initials: R
authors.lastname: Lencer
authors.forename: Kishore R
authors.initials: KR
authors.lastname: Kumar
authors.forename: Katja
authors.initials: K
authors.lastname: Lohmann
authors.forename: Johann
authors.initials: J
authors.lastname: Hagenah
authors.forename: Christine
authors.initials: C
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000150:complications / Q000235:genetics / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications / Q000235:genetics / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000235:genetics / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires