Highlights
- •Subthreshold depression (SubD) is a frequent problem in patients with PD and is near to triple prevalent than in controls.
- •Health-related and global perceived quality of life (QoL) are worse in subD than in non-depressed (nonD) PD patients.
- •A greater non-motor symptoms burden is associated with subthreshold depression in PD.
- •Specifically, fatigue, sleep problems, and neuropsychiatric symptoms seems to be related to subD in PD.
- •All this suggests that detection of subD in PD could be an important factor in clinical practice.
Abstract
Background
The role of subthreshold depression (subD) in Parkinson's Disease (PD) is not clear.
The present study aimed to compare the quality of life (QoL) in PD patients with subD
vs patients with no depressive disorder (nonD). Factors related to subD were identified.
Material and methods
PD patients and controls recruited from the COPPADIS cohort were included. SubD was
defined as Judd criteria. The 39-item Parkinson's disease Questionnaire (PDQ-39) and
the EUROHIS-QOL 8-item index (EUROHIS-QOL8) were used to assess QoL.
Results
The frequency of depressive symptoms was higher in PD patients (n = 694) than in controls (n = 207) (p < 0.0001): major depression, 16.1% vs 7.8%; minor depression, 16.7% vs 7.3%; subD,
17.4% vs 5.8%. Both health-related QoL (PDQ-39; 18.1 ± 12.8 vs 11.6 ± 10; p < 0.0001) and global QoL (EUROHIS-QOL8; 3.7 ± 0.5 vs 4 ± 0.5; p < 0.0001) were significantly
worse in subD (n = 120) than nonD (n = 348) PD patients. Non-motor Symptoms Scale (NMSS) total score was higher in subD
patients (45.9 ± 32 vs 29.1 ± 25.8;p < 0.0001). Non-motor symptoms burden (NMSS;OR = 1.019;95%CI 1.011–1.028; p < 0.0001),
neuropsychiatric symptoms (NPI; OR = 1.091; 95%CI 1.045–1.139; p < 0.0001), impulse
control behaviors (QUIP-RS; OR = 1.035; 95%CI 1.007–1063; p = 0.013), quality of sleep (PDSS; OR = 0.991; 95%CI 0.983–0.999; p = 0.042), and fatigue (VAFS-physical; OR = 1.185; 95%CI 1.086–1.293; p < 0.0001;
VAFS-mental; OR = 1.164; 95%CI 1.058–1.280; p = 0.0001) were related to subD after adjustment to age, disease duration, daily equivalent
levodopa dose, motor status (UPDRS-III), and living alone.
Conclusions
SubD is a frequent problem in patients with PD and is more prevalent in these patients
than in controls. QoL is worse and non-motor symptoms burden is greater in subD PD
patients.
Keywords
Abbreviations:
BDI-II (Beck Depression Inventory-II), FOG-Q (Freezing Of Gait Questionnaire), NMSS (Non-Motor Symptoms Scale), NPI (Neuropsychiatric Inventory), PD (Parkinson's disease), PD-CRS (Parkinson's Disease Cognitive Rating Scale), PDQ-39SI (39-item Parkinson's Disease Quality of Life Questionnaire Summary Index), PDSS (Parkinson's Disease Sleep Scale), QUIP-RS (Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale), S&E (Schwab & England Activities of Daily Living Scale), UPDRS (Unified Parkinson's Disease Rating Scale), VAFS (Visual Analog Fatigue Scale), VAS-Pain (Visual Analog Scale-Pain.)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A systematic review of prevalence studies of depression in Parkinson's disease.Mov. Disord. 2008; 23: 183-189
- Mood disorders in Parkinson's disease.Parkinsonism Relat. Disord. 2012; 18: S74-S76
- Subsyndromal symptomatic depression: a new mood disorder?.J. Clin. Psychiatry. 1994; 55: 18-28
- Subthreshold depression and subjective cognitive complaints in Parkinson's disease.Eur. J. Neurol. 2014; 21: 541-544
- Subthreshold depression in Parkinson's disease.Mov. Disord. 2011; 26: 1741-1744
- Subthreshold depression in Parkinson's disease.Int. J. Geriatr. Psychiatry. 2009; 24: 937-943
- Subthreshold depression in patients with Parkinson's disease and dementia _ clinical and demographic correlates.Int. J. Geriatr. Psychiatry. 2007; 22: 980-985
- A validation study of depressive syndromes in Parkinson's disease.Mov. Disord. 2008; 23: 538-546
- Quality of life and depression in Parkinson's disease.J. Neurol. Sci. 2006; 248: 151-157
- Depression is associated with impairment of ADL, non motor function in Parkinson's disease.Neurology. 2005; 64: 2134-2135
- COPPADIS Study Group. COPPADIS-2015 (COhort of Patient's with PArkinson's DIsease in Spain, 2015): an ongoing global Parkinson's disease Project about disease progression with more than 1,000 subjects included. Results from the baseline evaluation.Eur. J. Neurol. 2019; 26 (epub ahead of print): 1399-1407
- COPPADIS study group. COPPADIS-2015 (COhort of patients with PArkinson's DIsease in Spain, 2015), a global--clinical evaluations, serum biomarkers, genetic studies and neuroimaging--prospective, multicenter, non-interventional, long-term study on Parkinson's disease progression.BMC Neurol. 2016; 16: 26
- Beck Depression Inventory-Second Edition. Manual.The Psychological Corporation, San Antonio1996
- Diagnostic and Statical Manual of Mental Disorders.Fourth ed. American Psychiatric Association, Washington, DC1994
- Subsyndromal symptomatic depression: a new mood disorder?.J.Clin. Psychiatry. 1994; 55: 18-28
- The Parkinson's disease questionnaire (PDQ-39): development and validation of a Parkinson's disease summary index score.Age Ageing. 1997; 26: 353-357
- Impact of non-motor symptoms on health-related and perceived quality of life in Parkinson's disease.J. Neurol. Sci. 2013; 332: 136-140
- The EUROHIS-QOL 8-item index: comparative psychometric properties to its parent WHOQOL-BREF.Value Health. 2012; 15: 449-457
- A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.PLoS One. 2013; 8e57221
- Management of depression in Parkinson's disease: a systematic review.Mov. Disord. Clin. Pract. 2017; 4: 470-477
- COPPADIS Study Group. Non-motor symptoms burden, mood, and gait problems are the most significant factors contributing to a poor quality of life in non-demented Parkinson's disease patients: results from the COPPADIS Study Cohort.Parkinsonism Relat. Disord. 2019; 66 (epub ahead of print): 151-157
- NMSS validation group. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease.Mov. Disord. 2011; 26: 399-406
- Health-related quality of life as an outcome variable in Parkinson's disease.Ther. Adv. Neurol. Disord. 2012; 5: 105-117
- Are memory complaints predictive for dementia? A review of clinical and population based studies.Int. J. Geriatr. Psychiatry. 2000; 15: 983-991
- Subjective cognitive complaint in Parkinson's disease patients with normal cognition: canary in the coal mine?.Mov. Disord. 2020; (Online ahead of print)https://doi.org/10.1002/mds.28115
- The neuropathological basis for depression in Parkinson's disease.Parkinsonism Relat. Disord. 2009; 15: 144-148
- The association between motor subtypes and psychopathology in Parkinson's disease.Parkinsonism Relat. Disord. 2009; 15: 379-382
- Prognostic factors for the progression of Parkinson's disease: a systematic review.Mov. Disord. 2007; 22: 1839-1851
- on behalf of COPPADIS Study Group. Non-motor symptom burden is strongly correlated to motor complications in patients with Parkinson's disease.Eur. J. Neurol. 2020; 27 (epub ahead of print): 1210-1223
- Coppadis. Depression (BDI-II) in Parkinson's disease: prevalence, types, and variables associated to major, minor and subclinical depression in COPPADIS cohort [abstract].Mov. Disord. 2018; 33
- A three-year follow-up of major depression, dysthymia, minor depression and subsyndromal depression: results from a population-based study.Depress. Anxiety. 2007; 24: 62-65
- Do nonmotor symptoms in Parkinson's disease differ from normal aging?.Mov. Disord. 2011; 26: 2110-2113
Article info
Publication history
Published online: August 27, 2020
Accepted:
August 24,
2020
Received in revised form:
June 30,
2020
Received:
March 5,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
