- •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.
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.
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.
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.
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.)
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Published online: August 27, 2020
Accepted: August 24, 2020
Received in revised form: June 30, 2020
Received: March 5, 2020
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