Depression in veterans with Parkinson's disease: frequency, co‐morbidity, and healthcare utilization
Identifieur interne : 001081 ( Main/Exploration ); précédent : 001080; suivant : 001082Depression in veterans with Parkinson's disease: frequency, co‐morbidity, and healthcare utilization
Auteurs : Peijun Chen [États-Unis] ; Helen C. Kales [États-Unis] ; Daniel Weintraub [États-Unis] ; Frederic C. Blow [États-Unis] ; Lan Jiang [États-Unis] ; Rosalinda V. Ignacio [États-Unis] ; Alan M. Mellow [États-Unis]Source :
- 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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Mellow</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>VISN 11 Mental Health Service Line, Department of Veterans Affairs, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></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><affiliations><list><country><li>États-Unis</li></country><region><li>Michigan</li><li>Ohio</li><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><region name="Michigan"><name sortKey="Chen, Peijun" sort="Chen, Peijun" uniqKey="Chen P" first="Peijun" last="Chen">Peijun Chen</name></region><name sortKey="Blow, Frederic C" sort="Blow, Frederic C" uniqKey="Blow F" first="Frederic C." last="Blow">Frederic C. Blow</name><name sortKey="Blow, Frederic C" sort="Blow, Frederic C" uniqKey="Blow F" first="Frederic C." last="Blow">Frederic C. Blow</name><name sortKey="Chen, Peijun" sort="Chen, Peijun" uniqKey="Chen P" first="Peijun" last="Chen">Peijun Chen</name><name sortKey="Ignacio, Rosalinda V" sort="Ignacio, Rosalinda V" uniqKey="Ignacio R" first="Rosalinda V." last="Ignacio">Rosalinda V. Ignacio</name><name sortKey="Jiang, Lan" sort="Jiang, Lan" uniqKey="Jiang L" first="Lan" last="Jiang">Lan Jiang</name><name sortKey="Kales, Helen C" sort="Kales, Helen C" uniqKey="Kales H" first="Helen C." last="Kales">Helen C. Kales</name><name sortKey="Kales, Helen C" sort="Kales, Helen C" uniqKey="Kales H" first="Helen C." last="Kales">Helen C. Kales</name><name sortKey="Kales, Helen C" sort="Kales, Helen C" uniqKey="Kales H" first="Helen C." last="Kales">Helen C. Kales</name><name sortKey="Mellow, Alan M" sort="Mellow, Alan M" uniqKey="Mellow A" first="Alan M." last="Mellow">Alan M. Mellow</name><name sortKey="Mellow, Alan M" sort="Mellow, Alan M" uniqKey="Mellow A" first="Alan M." last="Mellow">Alan M. Mellow</name><name sortKey="Weintraub, Daniel" sort="Weintraub, Daniel" uniqKey="Weintraub D" first="Daniel" last="Weintraub">Daniel Weintraub</name><name sortKey="Weintraub, Daniel" sort="Weintraub, Daniel" uniqKey="Weintraub D" first="Daniel" last="Weintraub">Daniel Weintraub</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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