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The impact of depressive symptoms in early Parkinson disease

Identifieur interne : 000239 ( Pmc/Checkpoint ); précédent : 000238; suivant : 000240

The impact of depressive symptoms in early Parkinson disease

Auteurs : B Ravina ; R Camicioli ; P Como ; L Marsh ; J Jankovic ; D Weintraub ; J Elm

Source :

Neurology [ 0028-3878 ] ; 2007.

RBID : PMC:2031220

Abstract

Background

Depressive disorders may affect up to 50% of patients with Parkinson disease (PD) and are associated with increased disability and reduced quality of life. No previous study has systematically examined the impact of depressive symptoms in early, untreated PD.

Methods

We administered the 15-item Geriatric Depression Scale (GDS-15) as part of two NIH-sponsored phase II clinical trials in PD, enrolling 413 early, untreated PD subjects. We used linear mixed models to examine the relationship of depressive symptoms, measured by the GDS-15, with motor function and activities of daily living (ADLs), as measured by the Unified PD Rating Scale (UPDRS). A time-dependent Cox model was used to examine the effect of demographic and clinical outcome measures as predictors of investigator-determined time to need for symptomatic therapy for PD.

Results

A total of 114 (27.6%) subjects screened positive for depression during the average 14.6 months of follow-up. Forty percent of these subjects were neither treated with antidepressants nor referred for further psychiatric evaluation. Depression, as assessed by the GDS-15, was a significant predictor of more impairment in ADLs (p < 0.0001) and increased need for symptomatic therapy of PD (hazard ratio = 1.86; 95% CI 1.29, 2.68).

Conclusions

Clinically important depressive symptoms are common in early Parkinson disease (PD), but are often not treated. Depressive symptoms are an important contributor to disability and the decision to start symptomatic therapy for motor-related impairment in early PD, highlighting the broad importance of identifying and treating depression in this population.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2031220

DOI: 10.1212/01.wnl.0000268695.63392.10
PubMed: 17581943
PubMed Central: 2031220

Affiliations:

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PMC:2031220

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<author><name sortKey="Ravina, B" sort="Ravina, B" uniqKey="Ravina B" first="B" last="Ravina">B Ravina</name>
</author>
<author><name sortKey="Camicioli, R" sort="Camicioli, R" uniqKey="Camicioli R" first="R" last="Camicioli">R Camicioli</name>
</author>
<author><name sortKey="Como, P G" sort="Como, P G" uniqKey="Como P" first="P" last="Como">P Como</name>
</author>
<author><name sortKey="Marsh, L" sort="Marsh, L" uniqKey="Marsh L" first="L" last="Marsh">L Marsh</name>
</author>
<author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J Jankovic</name>
</author>
<author><name sortKey="Weintraub, D" sort="Weintraub, D" uniqKey="Weintraub D" first="D" last="Weintraub">D Weintraub</name>
</author>
<author><name sortKey="Elm, J" sort="Elm, J" uniqKey="Elm J" first="J" last="Elm">J Elm</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The impact of depressive symptoms in early Parkinson disease</title>
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</author>
<author><name sortKey="Camicioli, R" sort="Camicioli, R" uniqKey="Camicioli R" first="R" last="Camicioli">R Camicioli</name>
</author>
<author><name sortKey="Como, P G" sort="Como, P G" uniqKey="Como P" first="P" last="Como">P Como</name>
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<author><name sortKey="Marsh, L" sort="Marsh, L" uniqKey="Marsh L" first="L" last="Marsh">L Marsh</name>
</author>
<author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J Jankovic</name>
</author>
<author><name sortKey="Weintraub, D" sort="Weintraub, D" uniqKey="Weintraub D" first="D" last="Weintraub">D Weintraub</name>
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<author><name sortKey="Elm, J" sort="Elm, J" uniqKey="Elm J" first="J" last="Elm">J Elm</name>
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<series><title level="j">Neurology</title>
<idno type="ISSN">0028-3878</idno>
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<imprint><date when="2007">2007</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Depressive disorders may affect up to 50% of patients with Parkinson disease (PD) and are associated with increased disability and reduced quality of life. No previous study has systematically examined the impact of depressive symptoms in early, untreated PD.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We administered the 15-item Geriatric Depression Scale (GDS-15) as part of two NIH-sponsored phase II clinical trials in PD, enrolling 413 early, untreated PD subjects. We used linear mixed models to examine the relationship of depressive symptoms, measured by the GDS-15, with motor function and activities of daily living (ADLs), as measured by the Unified PD Rating Scale (UPDRS). A time-dependent Cox model was used to examine the effect of demographic and clinical outcome measures as predictors of investigator-determined time to need for symptomatic therapy for PD.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">A total of 114 (27.6%) subjects screened positive for depression during the average 14.6 months of follow-up. Forty percent of these subjects were neither treated with antidepressants nor referred for further psychiatric evaluation. Depression, as assessed by the GDS-15, was a significant predictor of more impairment in ADLs (<italic>p</italic>
 < 0.0001) and increased need for symptomatic therapy of PD (hazard ratio = 1.86; 95% CI 1.29, 2.68).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Clinically important depressive symptoms are common in early Parkinson disease (PD), but are often not treated. Depressive symptoms are an important contributor to disability and the decision to start symptomatic therapy for motor-related impairment in early PD, highlighting the broad importance of identifying and treating depression in this population.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><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">0401060</journal-id>
<journal-id journal-id-type="pubmed-jr-id">6069</journal-id>
<journal-id journal-id-type="nlm-ta">Neurology</journal-id>
<journal-title>Neurology</journal-title>
<issn pub-type="ppub">0028-3878</issn>
<issn pub-type="epub">1526-632X</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">17581943</article-id>
<article-id pub-id-type="pmc">2031220</article-id>
<article-id pub-id-type="doi">10.1212/01.wnl.0000268695.63392.10</article-id>
<article-id pub-id-type="manuscript">NIHMS29015</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>The impact of depressive symptoms in early Parkinson 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>
</contrib>
<contrib contrib-type="author"><name><surname>Camicioli</surname>
<given-names>R.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Como</surname>
<given-names>P.G.</given-names>
</name>
<degrees>PhD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Marsh</surname>
<given-names>L.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Jankovic</surname>
<given-names>J.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Weintraub</surname>
<given-names>D.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Elm</surname>
<given-names>J.</given-names>
</name>
<degrees>MA</degrees>
</contrib>
<aff id="A1">Department of Neurology (B.R., P.G.C.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology (R.C.), University of Alberta, Edmonton, Canada; Departments of Psychiatry and Neurology (L.M.), Johns Hopkins University, Baltimore, MD; Department of Neurology (J.J.), Baylor University, Houston, TX; Departments of Psychiatry and Neurology (D.W.), University of Pennsylvania, Philadelphia; and Department of Biostatistics (J.E.), Medical University of South Carolina, Charleston.</aff>
</contrib-group>
<author-notes><corresp id="CR1">Address correspondence and reprint requests to Dr. Bernard Ravina, 1351 Mt. Hope Ave., Suite 223, Rochester, NY 14620 <email>Bernard.ravina@ctcc.rochester.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>21</day>
<month>8</month>
<year>2007</year>
</pub-date>
<pub-date pub-type="epub"><day>20</day>
<month>6</month>
<year>2007</year>
</pub-date>
<pub-date pub-type="ppub"><day>24</day>
<month>7</month>
<year>2007</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>16</day>
<month>10</month>
<year>2007</year>
</pub-date>
<volume>69</volume>
<issue>4</issue>
<fpage>342</fpage>
<lpage>347</lpage>
<related-article journal-id-type="nlm-ta" journal-id="Neurology" related-article-type="commentary" page="E2" id="N0x1dea370N0x26e4908" xlink:href="17646622" ext-link-type="pubmed" vol="69"></related-article>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Depressive disorders may affect up to 50% of patients with Parkinson disease (PD) and are associated with increased disability and reduced quality of life. No previous study has systematically examined the impact of depressive symptoms in early, untreated PD.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We administered the 15-item Geriatric Depression Scale (GDS-15) as part of two NIH-sponsored phase II clinical trials in PD, enrolling 413 early, untreated PD subjects. We used linear mixed models to examine the relationship of depressive symptoms, measured by the GDS-15, with motor function and activities of daily living (ADLs), as measured by the Unified PD Rating Scale (UPDRS). A time-dependent Cox model was used to examine the effect of demographic and clinical outcome measures as predictors of investigator-determined time to need for symptomatic therapy for PD.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">A total of 114 (27.6%) subjects screened positive for depression during the average 14.6 months of follow-up. Forty percent of these subjects were neither treated with antidepressants nor referred for further psychiatric evaluation. Depression, as assessed by the GDS-15, was a significant predictor of more impairment in ADLs (<italic>p</italic>
 < 0.0001) and increased need for symptomatic therapy of PD (hazard ratio = 1.86; 95% CI 1.29, 2.68).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Clinically important depressive symptoms are common in early Parkinson disease (PD), but are often not treated. Depressive symptoms are an important contributor to disability and the decision to start symptomatic therapy for motor-related impairment in early PD, highlighting the broad importance of identifying and treating depression in this population.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Camicioli, R" sort="Camicioli, R" uniqKey="Camicioli R" first="R" last="Camicioli">R Camicioli</name>
<name sortKey="Como, P G" sort="Como, P G" uniqKey="Como P" first="P" last="Como">P Como</name>
<name sortKey="Elm, J" sort="Elm, J" uniqKey="Elm J" first="J" last="Elm">J Elm</name>
<name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J Jankovic</name>
<name sortKey="Marsh, L" sort="Marsh, L" uniqKey="Marsh L" first="L" last="Marsh">L Marsh</name>
<name sortKey="Ravina, B" sort="Ravina, B" uniqKey="Ravina B" first="B" last="Ravina">B Ravina</name>
<name sortKey="Weintraub, D" sort="Weintraub, D" uniqKey="Weintraub D" first="D" last="Weintraub">D Weintraub</name>
</noCountry>
</tree>
</affiliations>
</record>

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The impact of depressive symptoms in early Parkinson disease

The impact of depressive symptoms in early Parkinson disease

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Abstract

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