title: Depressive symptoms in Parkinson's disease and in non-neurological medical illnesses.
abstract: BACKGROUND
  Patients with neurological and non-neurological medical illnesses very often complain of depressive symptoms that are associated with cognitive and functional impairments. We compared the profile of depressive symptoms in Parkinson's disease (PD) patients with that of control subjects (CS) suffering from non-neurological medical illnesses.
  
  
  METHODS
  One-hundred PD patients and 100 CS were submitted to a structured clinical interview for identification of major depressive disorder (MDD) and minor depressive disorder (MIND), according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR), criteria. The Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI) were also administered to measure depression severity.
  
  
  RESULTS
  When considering the whole groups, there were no differences in depressive symptom frequency between PD and CS apart from worthlessness/guilt, and changes in appetite reduced rates in PD. Further, total scores and psychic and somatic subscores of HDRS and BDI did not differ between PD and CS. After we separated PD and CS in those with MDD, MIND, and no depression (NODEP), comparing total scores and psychic/somatic subscores of HDRS and BDI, we found increased total depression severity in NODEP PD and reduced severity of the psychic symptoms of depression in MDD PD, with no differences in MIND. However, the severity of individual symptom frequency of depression was not different between PD and CS in MDD, MIND, and NODEP groups.
  
  
  CONCLUSIONS
  Although MDD and MIND phenomenology in PD may be very similar to that of CS with non-neurological medical illnesses, neurological symptoms of PD may worsen (or confound) depression severity in patients with no formal/structured DSM-IV-TR, diagnosis of depressive mood disorders. Thus, a thorough assessment of depression in PD should take into consideration the different impacts of neurological manifestations on MDD, MIND, and NODEP.
authors.affiliation: I.R.C.C.S. Santa Lucia Foundation, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Assogna
authors.forename: Sabrina
authors.initials: S
authors.lastname: Fagioli
authors.forename: Luca
authors.initials: L
authors.lastname: Cravello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Meco
authors.forename: Mariangela
authors.initials: M
authors.lastname: Pierantozzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Stefani
authors.forename: Francesca
authors.initials: F
authors.lastname: Imperiale
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.forename: Francesco E
authors.initials: FE
authors.lastname: Pontieri
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Spalletta
keywords: Parkinson’s disease; depression; neuropsychiatry; nonmotor symptoms