Abstract
Depression is a common problem experienced by patients with Parkinson's disease (PD).
Identifying depression in PD is difficult and the determinants of depression in PD
are complex and debatable. Here we review our recent studies which have (i) examined
the validity of current depression rating scales in PD, (ii) introduced a self-reported
and validated strategy to identify a lifetime history of depression in PD, and (iii)
investigated genetic and non-genetic factors associated with depression in the context
of PD. Our research showed PD-specific cut-off values suitable to use for the Hamilton
Depression Scales (HAMD and HDI) and the Geriatric Depression Scale (GDS-15) when
dichotomising patients with and without a current depression. Using the GDS-15 specific
cut-off scores and a number of self-reported questions that screen for a lifetime
history of depression, we developed a novel method to dichotomise PD patients according
to current depression or a past history of depression. This method was applied in
a large-scale study examining the factors associated with depression in PD. We clarified
that the severity of PD is positively related to depression. We also showed that a
number of other clinical factors including a longer duration of PD, a younger PD onset
age, frequent falls, a history of anxiety disorder and memory problems were associated
with depression in PD. In addition to these clinical factors, we observed associations
between depression, and lower education levels, a history of smoking and a regular
use of non-aspirin bases NSAIDs or analgesics. No associations were found between
depression in PD and common genetic variations examined across the serotonin and dopamine
transporter genes. Our studies provide a focus for future intervention strategies.
Keywords
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Article info
Publication history
Published online: July 18, 2011
Accepted:
June 17,
2011
Received in revised form:
May 25,
2011
Received:
March 14,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
