The Course of Depressive Symptoms in Early Parkinson’s Disease
Identifieur interne : 000427 ( Pmc/Curation ); précédent : 000426; suivant : 000428The Course of Depressive Symptoms in Early Parkinson’s Disease
Auteurs : B. Ravina [États-Unis] ; J. Elm [États-Unis] ; R. Camicioli [Canada] ; P. G. Como [États-Unis] ; L. Marsh [États-Unis] ; J. Jankovic [États-Unis] ; D. Weintraub [États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2009.
Abstract
Little is known about the course of depressive symptoms in Parkinson’s disease (PD).
We studied the course of clinically significant depressive symptoms using data from two clinical trials that followed 413 early, untreated PD subjects for 12–18 months. We measured depressive symptoms with the 15-item Geriatric Depression Scale (GDS-15); a score of ≥5 indicates clinically significant depressive symptoms. We used a time-dependent Cox model to examine the association between demographic variables, PD severity, and medication use on the time to resolution of depressive symptoms.
114 of 413 (27.6%) subjects screened positive for depression during the study, with a median GDS-15 score of 6, indicating mild symptoms. Within 6 months, 47% of subjects experienced remission of clinically significant depressive symptoms. Subjects with mild depressive symptoms were more likely to develop moderate to severe depressive symptoms (GDS≥10) than those without prior symptoms (relative risk = 6.16). Increasing severity of depressive symptoms, older age, and longer PD duration predicted a lower likelihood of symptom resolution (hazard ratios 0.83 to 0.92).
Mild depressive symptoms have a variable course, with remission and development of more sustained and severe symptoms occurring over time. More severe depressive symptoms may herald a protracted course.
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DOI: 10.1002/mds.22572
PubMed: 19412939
PubMed Central: 2788307
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Ravina</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Elm, J" sort="Elm, J" uniqKey="Elm J" first="J." last="Elm">J. Elm</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Biostatistics, Medical University of South Carolina, Charleston, SC</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Sud</region></placeName><wicri:cityArea>Department of Biostatistics, Medical University of South Carolina, Charleston</wicri:cityArea></affiliation></author><author><name sortKey="Camicioli, R" sort="Camicioli, R" uniqKey="Camicioli R" first="R." last="Camicioli">R. Camicioli</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neurology, University of Alberta, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Neurology, University of Alberta, Edmonton</wicri:regionArea></affiliation></author><author><name sortKey="Como, P G" sort="Como, P G" uniqKey="Como P" first="P. G." last="Como">P. G. Como</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Marsh, L" sort="Marsh, L" uniqKey="Marsh L" first="L." last="Marsh">L. 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Weintraub</name><affiliation wicri:level="2"><nlm:aff id="A6">Departments of Psychiatry and Neurology, University of Pennsylvania, Philadelphia, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Departments of Psychiatry and Neurology, University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">Little is known about the course of depressive symptoms in Parkinson’s disease (PD).</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">We studied the course of clinically significant depressive symptoms using data from two clinical trials that followed 413 early, untreated PD subjects for 12–18 months. We measured depressive symptoms with the 15-item Geriatric Depression Scale (GDS-15); a score of ≥5 indicates clinically significant depressive symptoms. We used a time-dependent Cox model to examine the association between demographic variables, PD severity, and medication use on the time to resolution of depressive symptoms.</p></sec><sec id="S3"><title>Results</title><p id="P3">114 of 413 (27.6%) subjects screened positive for depression during the study, with a median GDS-15 score of 6, indicating mild symptoms. Within 6 months, 47% of subjects experienced remission of clinically significant depressive symptoms. Subjects with mild depressive symptoms were more likely to develop moderate to severe depressive symptoms (GDS≥10) than those without prior symptoms (relative risk = 6.16). Increasing severity of depressive symptoms, older age, and longer PD duration predicted a lower likelihood of symptom resolution (hazard ratios 0.83 to 0.92).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Mild depressive symptoms have a variable course, with remission and development of more sustained and severe symptoms occurring over time. More severe depressive symptoms may herald a protracted course.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8610688</journal-id><journal-id journal-id-type="pubmed-jr-id">5937</journal-id><journal-id journal-id-type="nlm-ta">Mov Disord</journal-id><journal-title>Movement disorders : official journal of the Movement Disorder Society</journal-title><issn pub-type="ppub">0885-3185</issn><issn pub-type="epub">1531-8257</issn></journal-meta><article-meta><article-id pub-id-type="pmid">19412939</article-id><article-id pub-id-type="pmc">2788307</article-id><article-id pub-id-type="doi">10.1002/mds.22572</article-id><article-id pub-id-type="manuscript">NIHMS157724</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The Course of Depressive Symptoms in Early Parkinson’s Disease</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Ravina</surname><given-names>B.</given-names></name><degrees>MD, MSCE</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Elm</surname><given-names>J.</given-names></name><degrees>MA</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Camicioli</surname><given-names>R.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Como</surname><given-names>P.G.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Marsh</surname><given-names>L.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Jankovic</surname><given-names>J.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Weintraub</surname><given-names>D.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A6">6</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY</aff><aff id="A2"><label>2</label>Department of Biostatistics, Medical University of South Carolina, Charleston, SC</aff><aff id="A3"><label>3</label>Department of Neurology, University of Alberta, Edmonton, Canada</aff><aff id="A4"><label>4</label>Departments of Psychiatry and Neurology, Johns Hopkins University, Baltimore, MD</aff><aff id="A5"><label>5</label>Department of Neurology, Baylor College of Medicine, Houston, TX</aff><aff id="A6"><label>6</label>Departments of Psychiatry and Neurology, University of Pennsylvania, Philadelphia, PA</aff><author-notes><corresp id="cor1">Address for Correspondence: Dr. Bernard Ravina, 1351 Mt. Hope Ave., Suite 223, Rochester, NY, 14620. Tel: (585) 275-7430, Fax: (585) 276-1870 <email>Bernard.ravina@ctcc.rochester.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>9</day><month>11</month><year>2009</year></pub-date><pub-date pub-type="ppub"><day>15</day><month>7</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>3</day><month>12</month><year>2009</year></pub-date><volume>24</volume><issue>9</issue><fpage>1306</fpage><lpage>1311</lpage><abstract><sec id="S1"><title>Background</title><p id="P1">Little is known about the course of depressive symptoms in Parkinson’s disease (PD).</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">We studied the course of clinically significant depressive symptoms using data from two clinical trials that followed 413 early, untreated PD subjects for 12–18 months. We measured depressive symptoms with the 15-item Geriatric Depression Scale (GDS-15); a score of ≥5 indicates clinically significant depressive symptoms. We used a time-dependent Cox model to examine the association between demographic variables, PD severity, and medication use on the time to resolution of depressive symptoms.</p></sec><sec id="S3"><title>Results</title><p id="P3">114 of 413 (27.6%) subjects screened positive for depression during the study, with a median GDS-15 score of 6, indicating mild symptoms. Within 6 months, 47% of subjects experienced remission of clinically significant depressive symptoms. Subjects with mild depressive symptoms were more likely to develop moderate to severe depressive symptoms (GDS≥10) than those without prior symptoms (relative risk = 6.16). Increasing severity of depressive symptoms, older age, and longer PD duration predicted a lower likelihood of symptom resolution (hazard ratios 0.83 to 0.92).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Mild depressive symptoms have a variable course, with remission and development of more sustained and severe symptoms occurring over time. More severe depressive symptoms may herald a protracted course.</p></sec></abstract><kwd-group><kwd>Parkinson’s disease</kwd><kwd>depression</kwd><kwd>clinical course</kwd><kwd>prognosis</kwd></kwd-group><contract-num rid="AT1">U01 AT004526-01
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