Subthreshold depression in Parkinson's disease
Identifieur interne : 000166 ( Istex/Corpus ); précédent : 000165; suivant : 000167Subthreshold depression in Parkinson's disease
Auteurs : Julia Reiff ; Nele Schmidt ; Bastian Riebe ; Robert Breternitz ; Josef Aldenhoff ; Günther Deuschl ; Karsten WittSource :
- Movement Disorders [ 0885-3185 ] ; 2011-08-01.
English descriptors
Abstract
Quality of life in Parkinson patients with subthreshold depression could be improved if the prevalence and symptom profile were better understood.
Our study used standard DSM‐IV and Judd criteria as well as motor, depression, and quality‐of‐life scales to investigate a sample of 110 nondemented Parkinson patients. This led to formation of nondepressed (48.2%), subthreshold depressed (25.5%), and depressed (26.4%) groups.
Quality of life was seen to be significantly lower in subthreshold depressed patients than in the nondepressed, and there were differences in the frequency of depressive symptoms that partially overlapped with nonmotor symptoms of vegetative origin in Parkinson's disease (appetite, sleep disorders). Key measures of depression (diminished interest/pleasure) were more frequent in the depressed group compared with the subthreshold depressed, although the motor functions of these 2 groups did not differ significantly.
The Beck Depression Inventory score ranging from 9 to 15 points differentiates subthreshold depressed from nondepressed and depressed patients best. © 2011 Movement Disorder Society
Url:
DOI: 10.1002/mds.23699
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<div type="abstract">Quality of life was seen to be significantly lower in subthreshold depressed patients than in the nondepressed, and there were differences in the frequency of depressive symptoms that partially overlapped with nonmotor symptoms of vegetative origin in Parkinson's disease (appetite, sleep disorders). Key measures of depression (diminished interest/pleasure) were more frequent in the depressed group compared with the subthreshold depressed, although the motor functions of these 2 groups did not differ significantly.</div>
<div type="abstract">The Beck Depression Inventory score ranging from 9 to 15 points differentiates subthreshold depressed from nondepressed and depressed patients best. © 2011 Movement Disorder Society</div>
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<contactDetails><email normalForm="k.witt@neurologie.uni-kiel.de">k.witt@neurologie.uni‐kiel.de</email>
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<affiliationGroup><affiliation xml:id="af1" countryCode="DE" type="organization"><unparsedAffiliation>Department of Psychiatry, Zentrum für Integrative Psychiatrie, Kiel, Germany</unparsedAffiliation>
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<affiliation xml:id="af2" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, University Medical Center Schleswig‐Holstein, Campus Kiel, Kiel, Germany</unparsedAffiliation>
</affiliation>
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<keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword>
<keyword xml:id="kwd2">subthreshold depression</keyword>
<keyword xml:id="kwd3">quality of life</keyword>
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<supportingInformation><p> Additional Supporting Information may be found in the online version of this article. </p>
<supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23699:MDS_23699_sm_suppfig1"></mediaResource>
<caption>Supporting Figure 1: PDQ‐39 subscores for ndPD, sdPD, and dPD. Data are given as mean ± SD, *P < .01, **P < 0.001 (Mann–Whitney test). The PDQ‐39 scores of the sdPD group fell between those of the ndPD and dPD patients, but the sdPD group only significantly differed from the dPD group in the subscore “emotional well‐being,” thus indicating that the sdPD group qualitatively mimicked the low quality of life (QoL) of dPD patients (ADL, activities of daily living).</caption>
</supportingInfoItem>
<supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23699:MDS_23699_sm_suppfig2"></mediaResource>
<caption>Supporting Figure 2: The nonlinear relation between QoL measured by a disease‐specific scale (PDQ‐39) and severity of symptoms of depression assessed with the Beck Depression Inventory (BDI). Small changes in BDI scores in the range of ndPD and sdPD (BDI < 16) led to a rapid decline in QoL.</caption>
</supportingInfoItem>
<supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23699:MDS_23699_sm_suppfig3"></mediaResource>
<caption>Supporting Figure 3: The screening instruments BDI, HAM‐D, MADRS, BAI (Beck Anxiety Inventory) and HAM‐A (Hamilton Anxiety Rating Scale) significantly differed in all groups (ndPD, sdPD, and dPD) at P < .01. BDI items were divided into 12 cognitively affective symptoms (caBDI) and 9 somatic symptoms (sBDI) according to a model of Endler et al (Endler NS, Rutherford A, Denisoff E. Beck depression inventory: exploring its dimensionality in a nonclinical population. J Clin Psychol. 1999;55:1307–1312).</caption>
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<supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23699:MDS_23699_sm_suppfig4a"></mediaResource>
<caption>Supporting Figure 4A: Receiver operating characteristic (ROC) curves for 3 screening instruments and the different patient groups. A: ROC curves for discriminating ndPD from sdPD and dPD. B: ROC curves for discriminating dPD from sdPD and ndPD (AUC, area under the curve). Sensitivity, specificity, and positive and negative predictive values for each score are given in Web Tables 1 and 2. Results are displayed as ROC curves that plot the proportion of patients correctly classified as depressed against the nondepressed who were incorrectly classified as depressed. Steeper curves indicate better discrimination. We also estimated the AUC under the ROC curve. When performance is at chance, the ROC curve is a straight line, indicated by the dotted line in each panel. AUC ranges between 0.5 (chance performance) and 1.0 (perfect discrimination).</caption>
</supportingInfoItem>
<supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23699:MDS_23699_sm_suppfig4b"></mediaResource>
<caption>Supporting Figure 4B</caption>
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<supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23699:MDS_23699_sm_authorroles"></mediaResource>
<caption>Author Roles and Disclosures</caption>
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<abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title>
<section xml:id="abs1-1"><title type="main">Background:</title>
<p>Quality of life in Parkinson patients with subthreshold depression could be improved if the prevalence and symptom profile were better understood.</p>
</section>
<section xml:id="abs1-2"><title type="main">Methods:</title>
<p>Our study used standard DSM‐IV and Judd criteria as well as motor, depression, and quality‐of‐life scales to investigate a sample of 110 nondemented Parkinson patients. This led to formation of nondepressed (48.2%), subthreshold depressed (25.5%), and depressed (26.4%) groups.</p>
</section>
<section xml:id="abs1-3"><title type="main">Results:</title>
<p>Quality of life was seen to be significantly lower in subthreshold depressed patients than in the nondepressed, and there were differences in the frequency of depressive symptoms that partially overlapped with nonmotor symptoms of vegetative origin in Parkinson's disease (appetite, sleep disorders). Key measures of depression (diminished interest/pleasure) were more frequent in the depressed group compared with the subthreshold depressed, although the motor functions of these 2 groups did not differ significantly.</p>
</section>
<section xml:id="abs1-4"><title type="main">Conclusions:</title>
<p>The Beck Depression Inventory score ranging from 9 to 15 points differentiates subthreshold depressed from nondepressed and depressed patients best. © 2011 Movement Disorder Society</p>
</section>
</abstract>
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<noteGroup><note xml:id="fn9"><p><b>Relevant conflicts of interest/financial disclosures:</b>
Nothing to report.</p>
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<note xml:id="fn10"><p>Full financial disclosures and author roles may be found in the online version of this article.</p>
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<name type="personal"><namePart type="given">Julia</namePart>
<namePart type="family">Reiff</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Department of Psychiatry, Zentrum für Integrative Psychiatrie, Kiel, Germany</affiliation>
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<name type="personal"><namePart type="given">Nele</namePart>
<namePart type="family">Schmidt</namePart>
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<name type="personal"><namePart type="given">Bastian</namePart>
<namePart type="family">Riebe</namePart>
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<affiliation>Department of Neurology, University Medical Center Schleswig‐Holstein, Campus Kiel, Kiel, Germany</affiliation>
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<name type="personal"><namePart type="given">Robert</namePart>
<namePart type="family">Breternitz</namePart>
<affiliation>Department of Neurology, University Medical Center Schleswig‐Holstein, Campus Kiel, Kiel, Germany</affiliation>
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<name type="personal"><namePart type="given">Josef</namePart>
<namePart type="family">Aldenhoff</namePart>
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<affiliation>Department of Psychiatry, Zentrum für Integrative Psychiatrie, Kiel, Germany</affiliation>
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<name type="personal"><namePart type="given">Günther</namePart>
<namePart type="family">Deuschl</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Neurology, University Medical Center Schleswig‐Holstein, Campus Kiel, Kiel, Germany</affiliation>
<role><roleTerm type="text">author</roleTerm>
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<name type="personal"><namePart type="given">Karsten</namePart>
<namePart type="family">Witt</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Neurology, University Medical Center Schleswig‐Holstein, Campus Kiel, Kiel, Germany</affiliation>
<affiliation>Department of Neurology. University Medical Center Schleswig‐Holstein, Campus Kiel, Schittenhelmstrasse 10, 24105 Kiel, Germany</affiliation>
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<abstract>Quality of life in Parkinson patients with subthreshold depression could be improved if the prevalence and symptom profile were better understood.</abstract>
<abstract>Our study used standard DSM‐IV and Judd criteria as well as motor, depression, and quality‐of‐life scales to investigate a sample of 110 nondemented Parkinson patients. This led to formation of nondepressed (48.2%), subthreshold depressed (25.5%), and depressed (26.4%) groups.</abstract>
<abstract>Quality of life was seen to be significantly lower in subthreshold depressed patients than in the nondepressed, and there were differences in the frequency of depressive symptoms that partially overlapped with nonmotor symptoms of vegetative origin in Parkinson's disease (appetite, sleep disorders). Key measures of depression (diminished interest/pleasure) were more frequent in the depressed group compared with the subthreshold depressed, although the motor functions of these 2 groups did not differ significantly.</abstract>
<abstract>The Beck Depression Inventory score ranging from 9 to 15 points differentiates subthreshold depressed from nondepressed and depressed patients best. © 2011 Movement Disorder Society</abstract>
<note type="content">*Relevant conflicts of interest/financial disclosures: Nothing to report.</note>
<note type="content">*Full financial disclosures and author roles may be found in the online version of this article.</note>
<subject lang="en"><genre>keywords</genre>
<topic>Parkinson's disease</topic>
<topic>subthreshold depression</topic>
<topic>quality of life</topic>
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<note type="content"> Additional Supporting Information may be found in the online version of this article.Supporting Info Item: Supporting Figure 1: PDQ‐39 subscores for ndPD, sdPD, and dPD. Data are given as mean ± SD, *P < .01, **P < 0.001 (Mann–Whitney test). The PDQ‐39 scores of the sdPD group fell between those of the ndPD and dPD patients, but the sdPD group only significantly differed from the dPD group in the subscore “emotional well‐being,” thus indicating that the sdPD group qualitatively mimicked the low quality of life (QoL) of dPD patients (ADL, activities of daily living). - Supporting Figure 2: The nonlinear relation between QoL measured by a disease‐specific scale (PDQ‐39) and severity of symptoms of depression assessed with the Beck Depression Inventory (BDI). Small changes in BDI scores in the range of ndPD and sdPD (BDI < 16) led to a rapid decline in QoL. - Supporting Figure 3: The screening instruments BDI, HAM‐D, MADRS, BAI (Beck Anxiety Inventory) and HAM‐A (Hamilton Anxiety Rating Scale) significantly differed in all groups (ndPD, sdPD, and dPD) at P < .01. BDI items were divided into 12 cognitively affective symptoms (caBDI) and 9 somatic symptoms (sBDI) according to a model of Endler et al (Endler NS, Rutherford A, Denisoff E. Beck depression inventory: exploring its dimensionality in a nonclinical population. J Clin Psychol. 1999;55:1307–1312). - Supporting Figure 4A: Receiver operating characteristic (ROC) curves for 3 screening instruments and the different patient groups. A: ROC curves for discriminating ndPD from sdPD and dPD. B: ROC curves for discriminating dPD from sdPD and ndPD (AUC, area under the curve). Sensitivity, specificity, and positive and negative predictive values for each score are given in Web Tables 1 and 2. Results are displayed as ROC curves that plot the proportion of patients correctly classified as depressed against the nondepressed who were incorrectly classified as depressed. Steeper curves indicate better discrimination. We also estimated the AUC under the ROC curve. When performance is at chance, the ROC curve is a straight line, indicated by the dotted line in each panel. AUC ranges between 0.5 (chance performance) and 1.0 (perfect discrimination). - Supporting Figure 4B - Author Roles and Disclosures - </note>
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<topic>Brief Report</topic>
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<identifier type="ISSN">0885-3185</identifier>
<identifier type="eISSN">1531-8257</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-8257</identifier>
<identifier type="PublisherID">MDS</identifier>
<part><date>2011</date>
<detail type="volume"><caption>vol.</caption>
<number>26</number>
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