Depression in veterans with Parkinson's disease: frequency, co‐morbidity, and healthcare utilization
Identifieur interne : 001537 ( Main/Corpus ); précédent : 001536; suivant : 001538Depression in veterans with Parkinson's disease: frequency, co‐morbidity, and healthcare utilization
Auteurs : Peijun Chen ; Helen C. Kales ; Daniel Weintraub ; Frederic C. Blow ; Lan Jiang ; Rosalinda V. Ignacio ; Alan M. MellowSource :
- International Journal of Geriatric Psychiatry [ 0885-6230 ] ; 2007-06.
English descriptors
Abstract
Objective: To determine the frequency of depression in Parkinson's disease (PD) in routine clinical care, and to examine its association with co‐morbid psychiatric and medical conditions and healthcare utilization. Methods: Depression diagnoses and healthcare utilization data for all male veterans with PD age 55 or older seen in fiscal year 2002 (n = 41,162) were analyzed using Department of Veterans Affairs (VA) national databases. Frequencies of co‐morbid disorders and healthcare utilization were determined for depressed and non‐depressed patients; associations with depression were examined using multivariate logistic regression models. Results: A depression diagnosis was recorded for 18.5% of PD patients, including major depression in 3.9%. Depression decreased in frequency and severity with increasing age. In multivariate logistic regression models, depressed patients had significantly greater psychiatric and medical co‐morbidity, including dementia, psychosis, stroke, congestive heart failure, diabetes, and chronic obstructive pulmonary disease than non‐depressed patients (all p < 0.01). Depressed PD patients were also significantly more likely to have medical (OR = 1.34, 95% CI = 1.25–1.44) and psychiatric hospitalizations (OR = 2.14, 95% CI = 1.83–2.51), and had more outpatient visits (p < 0.01), than non‐depressed PD patients in adjusted models. Conclusion: Depression in PD in non‐tertiary care settings may not be as common or as severe as that seen in specialty care, though these findings also may reflect under‐recognition or diagnostic imprecision. The occurrence of depression in PD is associated with greater psychiatric and medical co‐morbidity, and greater healthcare utilization. These findings suggest that screening for depression in PD is important and should be embedded in a comprehensive psychiatric, neuropsychological, and medical evaluation. Copyright © 2006 John Wiley & Sons, Ltd.
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DOI: 10.1002/gps.1712
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Kales</name><affiliation><mods:affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA</mods:affiliation></affiliation></author><author><name sortKey="Weintraub, Daniel" sort="Weintraub, Daniel" uniqKey="Weintraub D" first="Daniel" last="Weintraub">Daniel Weintraub</name><affiliation><mods:affiliation>Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia VA Medical Center, Philadelphia, PA, USA</mods:affiliation></affiliation></author><author><name sortKey="Blow, Frederic C" sort="Blow, Frederic C" uniqKey="Blow F" first="Frederic C." last="Blow">Frederic C. 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Ignacio</name><affiliation><mods:affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</mods:affiliation></affiliation></author><author><name sortKey="Mellow, Alan M" sort="Mellow, Alan M" uniqKey="Mellow A" first="Alan M." last="Mellow">Alan M. Mellow</name><affiliation><mods:affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>VISN 11 Mental Health Service Line, Department of Veterans Affairs, Ann Arbor, MI, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Geriatric Psychiatry</title><title level="j" type="sub">A journal of the psychiatry of late life and allied sciences</title><title level="j" type="abbrev">Int. J. Geriat. Psychiatry</title><idno type="ISSN">0885-6230</idno><idno type="eISSN">1099-1166</idno><imprint><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2007-06">2007-06</date><biblScope unit="volume">22</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="543">543</biblScope><biblScope unit="page" to="548">548</biblScope></imprint><idno type="ISSN">0885-6230</idno></series><idno type="istex">051B8BFBA2159D4E1984F71067E62FA0C25C8C3D</idno><idno type="DOI">10.1002/gps.1712</idno><idno type="ArticleID">GPS1712</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-6230</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>co‐morbidity</term><term>depression</term><term>frequency</term><term>healthcare utilization</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To determine the frequency of depression in Parkinson's disease (PD) in routine clinical care, and to examine its association with co‐morbid psychiatric and medical conditions and healthcare utilization. Methods: Depression diagnoses and healthcare utilization data for all male veterans with PD age 55 or older seen in fiscal year 2002 (n = 41,162) were analyzed using Department of Veterans Affairs (VA) national databases. Frequencies of co‐morbid disorders and healthcare utilization were determined for depressed and non‐depressed patients; associations with depression were examined using multivariate logistic regression models. Results: A depression diagnosis was recorded for 18.5% of PD patients, including major depression in 3.9%. Depression decreased in frequency and severity with increasing age. In multivariate logistic regression models, depressed patients had significantly greater psychiatric and medical co‐morbidity, including dementia, psychosis, stroke, congestive heart failure, diabetes, and chronic obstructive pulmonary disease than non‐depressed patients (all p < 0.01). Depressed PD patients were also significantly more likely to have medical (OR = 1.34, 95% CI = 1.25–1.44) and psychiatric hospitalizations (OR = 2.14, 95% CI = 1.83–2.51), and had more outpatient visits (p < 0.01), than non‐depressed PD patients in adjusted models. Conclusion: Depression in PD in non‐tertiary care settings may not be as common or as severe as that seen in specialty care, though these findings also may reflect under‐recognition or diagnostic imprecision. The occurrence of depression in PD is associated with greater psychiatric and medical co‐morbidity, and greater healthcare utilization. These findings suggest that screening for depression in PD is important and should be embedded in a comprehensive psychiatric, neuropsychological, and medical evaluation. Copyright © 2006 John Wiley & Sons, Ltd.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Peijun Chen</name><affiliations><json:string>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</json:string><json:string>Currently at Department of Psychiatry, Case Western Reserve University, Cleveland VA Medical Center, Cleveland, OH, USA</json:string></affiliations></json:item><json:item><name>Helen C. Kales</name><affiliations><json:string>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</json:string><json:string>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</json:string><json:string>Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA</json:string></affiliations></json:item><json:item><name>Daniel Weintraub</name><affiliations><json:string>Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA</json:string><json:string>Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia VA Medical Center, Philadelphia, PA, USA</json:string></affiliations></json:item><json:item><name>Frederic C. Blow</name><affiliations><json:string>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</json:string><json:string>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</json:string></affiliations></json:item><json:item><name>Lan Jiang</name><affiliations><json:string>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</json:string></affiliations></json:item><json:item><name>Rosalinda V. Ignacio</name><affiliations><json:string>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</json:string></affiliations></json:item><json:item><name>Alan M. Mellow</name><affiliations><json:string>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</json:string><json:string>VISN 11 Mental Health Service Line, Department of Veterans Affairs, Ann Arbor, MI, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>depression</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>frequency</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>co‐morbidity</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>healthcare utilization</value></json:item></subject><articleId><json:string>GPS1712</json:string></articleId><language><json:string>eng</json:string></language><abstract>Objective: To determine the frequency of depression in Parkinson's disease (PD) in routine clinical care, and to examine its association with co‐morbid psychiatric and medical conditions and healthcare utilization. Methods: Depression diagnoses and healthcare utilization data for all male veterans with PD age 55 or older seen in fiscal year 2002 (n = 41,162) were analyzed using Department of Veterans Affairs (VA) national databases. Frequencies of co‐morbid disorders and healthcare utilization were determined for depressed and non‐depressed patients; associations with depression were examined using multivariate logistic regression models. Results: A depression diagnosis was recorded for 18.5% of PD patients, including major depression in 3.9%. Depression decreased in frequency and severity with increasing age. In multivariate logistic regression models, depressed patients had significantly greater psychiatric and medical co‐morbidity, including dementia, psychosis, stroke, congestive heart failure, diabetes, and chronic obstructive pulmonary disease than non‐depressed patients (all p > 0.01). Depressed PD patients were also significantly more likely to have medical (OR = 1.34, 95% CI = 1.25–1.44) and psychiatric hospitalizations (OR = 2.14, 95% CI = 1.83–2.51), and had more outpatient visits (p > 0.01), than non‐depressed PD patients in adjusted models. Conclusion: Depression in PD in non‐tertiary care settings may not be as common or as severe as that seen in specialty care, though these findings also may reflect under‐recognition or diagnostic imprecision. The occurrence of depression in PD is associated with greater psychiatric and medical co‐morbidity, and greater healthcare utilization. These findings suggest that screening for depression in PD is important and should be embedded in a comprehensive psychiatric, neuropsychological, and medical evaluation. Copyright © 2006 John Wiley & Sons, Ltd.</abstract><qualityIndicators><score>6.404</score><pdfVersion>1.3</pdfVersion><pdfPageSize>567 x 737 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1932</abstractCharCount><pdfWordCount>3404</pdfWordCount><pdfCharCount>23487</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>257</abstractWordCount></qualityIndicators><title>Depression in veterans with Parkinson's disease: frequency, co‐morbidity, and healthcare utilization</title><genre><json:string>article</json:string></genre><host><volume>22</volume><publisherId><json:string>GPS</json:string></publisherId><pages><total>6</total><last>548</last><first>543</first></pages><issn><json:string>0885-6230</json:string></issn><issue>6</issue><subject><json:item><value>Research 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Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</affiliation><affiliation>Currently at Department of Psychiatry, Case Western Reserve University, Cleveland VA Medical Center, Cleveland, OH, USA</affiliation></author><author><persName><forename type="first">Helen C.</forename><surname>Kales</surname></persName><affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</affiliation><affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</affiliation><affiliation>Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA</affiliation></author><author><persName><forename type="first">Daniel</forename><surname>Weintraub</surname></persName><affiliation>Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA</affiliation><affiliation>Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia VA Medical Center, Philadelphia, PA, USA</affiliation></author><author><persName><forename type="first">Frederic C.</forename><surname>Blow</surname></persName><affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</affiliation><affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</affiliation></author><author><persName><forename type="first">Lan</forename><surname>Jiang</surname></persName><affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</affiliation></author><author><persName><forename type="first">Rosalinda V.</forename><surname>Ignacio</surname></persName><affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</affiliation></author><author><persName><forename type="first">Alan M.</forename><surname>Mellow</surname></persName><affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</affiliation><affiliation>VISN 11 Mental Health Service Line, Department of Veterans Affairs, Ann Arbor, MI, USA</affiliation></author></analytic><monogr><title level="j">International Journal of Geriatric Psychiatry</title><title level="j" type="sub">A journal of the psychiatry of late life and allied sciences</title><title level="j" type="abbrev">Int. J. Geriat. Psychiatry</title><idno type="pISSN">0885-6230</idno><idno type="eISSN">1099-1166</idno><idno type="DOI">10.1002/(ISSN)1099-1166</idno><imprint><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2007-06"></date><biblScope unit="volume">22</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="543">543</biblScope><biblScope unit="page" to="548">548</biblScope></imprint></monogr><idno type="istex">051B8BFBA2159D4E1984F71067E62FA0C25C8C3D</idno><idno type="DOI">10.1002/gps.1712</idno><idno type="ArticleID">GPS1712</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2007</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective: To determine the frequency of depression in Parkinson's disease (PD) in routine clinical care, and to examine its association with co‐morbid psychiatric and medical conditions and healthcare utilization. Methods: Depression diagnoses and healthcare utilization data for all male veterans with PD age 55 or older seen in fiscal year 2002 (n = 41,162) were analyzed using Department of Veterans Affairs (VA) national databases. Frequencies of co‐morbid disorders and healthcare utilization were determined for depressed and non‐depressed patients; associations with depression were examined using multivariate logistic regression models. Results: A depression diagnosis was recorded for 18.5% of PD patients, including major depression in 3.9%. Depression decreased in frequency and severity with increasing age. In multivariate logistic regression models, depressed patients had significantly greater psychiatric and medical co‐morbidity, including dementia, psychosis, stroke, congestive heart failure, diabetes, and chronic obstructive pulmonary disease than non‐depressed patients (all p < 0.01). Depressed PD patients were also significantly more likely to have medical (OR = 1.34, 95% CI = 1.25–1.44) and psychiatric hospitalizations (OR = 2.14, 95% CI = 1.83–2.51), and had more outpatient visits (p < 0.01), than non‐depressed PD patients in adjusted models. Conclusion: Depression in PD in non‐tertiary care settings may not be as common or as severe as that seen in specialty care, though these findings also may reflect under‐recognition or diagnostic imprecision. The occurrence of depression in PD is associated with greater psychiatric and medical co‐morbidity, and greater healthcare utilization. These findings suggest that screening for depression in PD is important and should be embedded in a comprehensive psychiatric, neuropsychological, and medical evaluation. 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Psychiatry</title></titleGroup></publicationMeta><publicationMeta level="part" position="60"><doi origin="wiley" registered="yes">10.1002/gps.v22:6</doi><numberingGroup><numbering type="journalVolume" number="22">22</numbering><numbering type="journalIssue">6</numbering></numberingGroup><coverDate startDate="2007-06">June 2007</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="50" status="forIssue"><doi origin="wiley" registered="yes">10.1002/gps.1712</doi><idGroup><id type="unit" value="GPS1712"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="publisher">Copyright © 2006 John Wiley & Sons, Ltd.</copyright><eventGroup><event type="manuscriptReceived" date="2006-01-26"></event><event type="manuscriptAccepted" date="2006-07-26"></event><event 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type="figureTotal" number="0"></count><count type="tableTotal" number="4"></count><count type="referenceTotal" number="33"></count></countGroup><titleGroup><title type="main" xml:lang="en">Depression in veterans with Parkinson's disease: frequency, co‐morbidity, and healthcare utilization</title><title type="short" xml:lang="en">DEPRESSION IN PARKINSON'S DISEASE</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Peijun</givenNames><familyName>Chen</familyName></personName><contactDetails><email>Peijun.chen@med.va.gov</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1 #af3 #af4"><personName><givenNames>Helen C.</givenNames><familyName>Kales</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af5 #af6"><personName><givenNames>Daniel</givenNames><familyName>Weintraub</familyName></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1 #af3"><personName><givenNames>Frederic C.</givenNames><familyName>Blow</familyName></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Lan</givenNames><familyName>Jiang</familyName></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Rosalinda V.</givenNames><familyName>Ignacio</familyName></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1 #af7"><personName><givenNames>Alan M.</givenNames><familyName>Mellow</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Currently at Department of Psychiatry, Case Western Reserve University, Cleveland VA Medical Center, Cleveland, OH, USA</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="US" type="organization"><unparsedAffiliation>Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="US" type="organization"><unparsedAffiliation>Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="US" type="organization"><unparsedAffiliation>Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia VA Medical Center, Philadelphia, PA, USA</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="US" type="organization"><unparsedAffiliation>VISN 11 Mental Health Service Line, Department of Veterans Affairs, Ann Arbor, MI, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">depression</keyword><keyword xml:id="kwd2">Parkinson's disease</keyword><keyword xml:id="kwd3">frequency</keyword><keyword xml:id="kwd4">co‐morbidity</keyword><keyword xml:id="kwd5">healthcare utilization</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Objective</title><p>To determine the frequency of depression in Parkinson's disease (PD) in routine clinical care, and to examine its association with co‐morbid psychiatric and medical conditions and healthcare utilization.</p></section><section xml:id="abs1-2"><title type="main">Methods</title><p>Depression diagnoses and healthcare utilization data for all male veterans with PD age 55 or older seen in fiscal year 2002 (<i>n</i> = 41,162) were analyzed using Department of Veterans Affairs (VA) national databases. Frequencies of co‐morbid disorders and healthcare utilization were determined for depressed and non‐depressed patients; associations with depression were examined using multivariate logistic regression models.</p></section><section xml:id="abs1-3"><title type="main">Results</title><p>A depression diagnosis was recorded for 18.5% of PD patients, including major depression in 3.9%. Depression decreased in frequency and severity with increasing age. In multivariate logistic regression models, depressed patients had significantly greater psychiatric and medical co‐morbidity, including dementia, psychosis, stroke, congestive heart failure, diabetes, and chronic obstructive pulmonary disease than non‐depressed patients (all <i>p</i> < 0.01). Depressed PD patients were also significantly more likely to have medical (OR = 1.34, 95% CI = 1.25–1.44) and psychiatric hospitalizations (OR = 2.14, 95% CI = 1.83–2.51), and had more outpatient visits (<i>p</i> < 0.01), than non‐depressed PD patients in adjusted models.</p></section><section xml:id="abs1-4"><title type="main">Conclusion</title><p>Depression in PD in non‐tertiary care settings may not be as common or as severe as that seen in specialty care, though these findings also may reflect under‐recognition or diagnostic imprecision. The occurrence of depression in PD is associated with greater psychiatric and medical co‐morbidity, and greater healthcare utilization. These findings suggest that screening for depression in PD is important and should be embedded in a comprehensive psychiatric, neuropsychological, and medical evaluation. Copyright © 2006 John Wiley & Sons, Ltd.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Depression in veterans with Parkinson's disease: frequency, co‐morbidity, and healthcare utilization</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>DEPRESSION IN PARKINSON'S DISEASE</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Depression in veterans with Parkinson's disease: frequency, co‐morbidity, and healthcare utilization</title></titleInfo><name type="personal"><namePart type="given">Peijun</namePart><namePart type="family">Chen</namePart><affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</affiliation><affiliation>Currently at Department of Psychiatry, Case Western Reserve University, Cleveland VA Medical Center, Cleveland, OH, USA</affiliation><description>Correspondence: Cleveland VA Medical Center, Psychiatry Service 116A (B), 10000 Brecksville Road, Brecksville, Oh 44141, USA.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Helen C.</namePart><namePart type="family">Kales</namePart><affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</affiliation><affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</affiliation><affiliation>Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Daniel</namePart><namePart type="family">Weintraub</namePart><affiliation>Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA</affiliation><affiliation>Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia VA Medical Center, Philadelphia, PA, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Frederic C.</namePart><namePart type="family">Blow</namePart><affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</affiliation><affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lan</namePart><namePart type="family">Jiang</namePart><affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rosalinda V.</namePart><namePart type="family">Ignacio</namePart><affiliation>VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alan M.</namePart><namePart type="family">Mellow</namePart><affiliation>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA</affiliation><affiliation>VISN 11 Mental Health Service Line, Department of Veterans Affairs, Ann Arbor, MI, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>John Wiley & Sons, Ltd.</publisher><place><placeTerm type="text">Chichester, UK</placeTerm></place><dateIssued encoding="w3cdtf">2007-06</dateIssued><dateCaptured encoding="w3cdtf">2006-01-26</dateCaptured><dateValid encoding="w3cdtf">2006-07-26</dateValid><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">4</extent><extent unit="references">33</extent></physicalDescription><abstract lang="en">Objective: To determine the frequency of depression in Parkinson's disease (PD) in routine clinical care, and to examine its association with co‐morbid psychiatric and medical conditions and healthcare utilization. Methods: Depression diagnoses and healthcare utilization data for all male veterans with PD age 55 or older seen in fiscal year 2002 (n = 41,162) were analyzed using Department of Veterans Affairs (VA) national databases. Frequencies of co‐morbid disorders and healthcare utilization were determined for depressed and non‐depressed patients; associations with depression were examined using multivariate logistic regression models. Results: A depression diagnosis was recorded for 18.5% of PD patients, including major depression in 3.9%. Depression decreased in frequency and severity with increasing age. In multivariate logistic regression models, depressed patients had significantly greater psychiatric and medical co‐morbidity, including dementia, psychosis, stroke, congestive heart failure, diabetes, and chronic obstructive pulmonary disease than non‐depressed patients (all p < 0.01). Depressed PD patients were also significantly more likely to have medical (OR = 1.34, 95% CI = 1.25–1.44) and psychiatric hospitalizations (OR = 2.14, 95% CI = 1.83–2.51), and had more outpatient visits (p < 0.01), than non‐depressed PD patients in adjusted models. Conclusion: Depression in PD in non‐tertiary care settings may not be as common or as severe as that seen in specialty care, though these findings also may reflect under‐recognition or diagnostic imprecision. The occurrence of depression in PD is associated with greater psychiatric and medical co‐morbidity, and greater healthcare utilization. These findings suggest that screening for depression in PD is important and should be embedded in a comprehensive psychiatric, neuropsychological, and medical evaluation. Copyright © 2006 John Wiley & Sons, Ltd.</abstract><subject lang="en"><genre>Keywords</genre><topic>depression</topic><topic>Parkinson's disease</topic><topic>frequency</topic><topic>co‐morbidity</topic><topic>healthcare utilization</topic></subject><relatedItem type="host"><titleInfo><title>International Journal of Geriatric Psychiatry</title><subTitle>A journal of the psychiatry of late life and allied sciences</subTitle></titleInfo><titleInfo type="abbreviated"><title>Int. J. Geriat. Psychiatry</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-6230</identifier><identifier type="eISSN">1099-1166</identifier><identifier type="DOI">10.1002/(ISSN)1099-1166</identifier><identifier type="PublisherID">GPS</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>22</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>543</start><end>548</end><total>6</total></extent></part></relatedItem><identifier type="istex">051B8BFBA2159D4E1984F71067E62FA0C25C8C3D</identifier><identifier type="DOI">10.1002/gps.1712</identifier><identifier type="ArticleID">GPS1712</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2006 John Wiley & Sons, Ltd.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>John Wiley & Sons, Ltd.</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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