Depression Associated With Parkinson's Disease And Its Effect On Motor Function

Objective: To evaluate the prevalence and factors influencing depression in patients of Parkinson's disease (PD).Methods: 63 PD patients were included in this study,and everybody performed a structured interview and a neurological examination, including Unified Parkinson's Disease Rating scale (UPDRS), Hoehn and Yahr scale (H–Y), Schwab–England disability scale, improved Webster scale, Hamilton rating scale for depression with 17 items (HAMD-17), Hamilton rating scale for anxiety (HAMA), Self-rating depression scale (SDS) and Zung self-rating anxiety scale (SAS). The prevalence and factors associated with depression were investigated.Results:1. The prevalence of depression in PD was established at the level of 71.43%, and associated with longer duration, high H-Y score (P<0.05), while there were no significant deviation with gender, age of onset, education degree, clinical classification, type and time of medication use for PD (P>0.05).2. Patients with moderate to major depression scored significantly higher in all UPDRS scales and in Schwab–England disability scale, improved Webster scale, compared to patients without depression and with minor depression (P<0.05). Patients with minor depression only scored higher in Schwab–England disability scale than non-depressed patients (P<0.05).3. The prevalence of anxiety was 53.97%, and the prevalence of comorbidity of depression and anxiety was 49.21%. 4. Patients with depression always showed anxiety/ somatization, blockage, dyssomnia, cognitive handicap, and weight lose by turns. Patients with minor depression scored significantly lower than non-depressed one in total score of HAMD, and in items of anxiety/ somatization, dyssomnia, blockage (P<0.05) ,but there were no significant deviation in items of cognitive handicap or weight lose (P>0.05), and no significant deviation only in weight lose compared to patients with moderate to major depression (P>0.05). There were significant deviation of above parameters of HAMD between patients with moderate to major depression and non-depressed patients (P<0.05).Conclusions: The prevalence of depression in PD was 71.43%, and associated with longer duration, more serious condition of PD, while it was insignificant with gender, age of onset ,education degree, clinical classification and type and time of medication use. The prevalence of anxiety was high too, and the comorbidity of depression and anxiety was common. Patients with depression in PD frequently showed anxiety/ somatization, blockage, dyssomnia, cognitive handicap.Objective: To investigate the effect of depression and the influence of antidepressant therapy on motor function of Parkinson's disease.Methods: 63 PD patients were included in this study, who were separated into three group, non-depressed group, depression with antidepressant group and depression without antidepressant group. Everyone was assessed with Unified Parkinson's Disease Rating scale (UPDRS), Hoehn and Yahr scale (H–Y), Schwab–England disability scale, improved Webster scale, Hamilton rating scale for depression with 17 items (HAMD-17), Hamilton rating scale for anxiety (HAMA), Self-rating depression scale (SDS) and Zung self-rating anxiety scale(SAS),and assessed again 4 months later. Dates were compared between these three groups. Results:1. The score of HAMD in non-depressed group was higher later than before significantly (P<0.05), and score of UPDRS, UPDRSⅢdidn't appear deviation respectively between later and before (P>0.05); The score of UPDRSⅢin depression without antidepressant group was higher later (P<0.05),while there were no significant deviation in score of UPDRS and HAMD between later and before (P>0.05). The score of HAMD in depression with antidepressant group was lower significantly later (P<0.05), but score of UPDRS, UPDRSⅢrespectively showed insignificant deviation between later and before (P>0.05).2. Repeated measures of analysis of variance about the score of HAMD, UPDRS, UPDRSⅢshowed that all parameters in non-depressed group deviated significantly compared to other groups(P<0.05), and that there were no significant deviation between depression without antidepressant group and depression with antidepressant group (P>0.05).Conclusions: With PD following, depressed mood would occur, and would worsen motor function. However, it cannot conclude that antidepressant therapy would effect motor function of PD. The diagnosis of depression was difficult, and recognition of antidepressant therapy was lack, which warranted increased clinical awareness, early diagnosis and treatment.