Depression in Parkinson's disease

Article Abstract:

Parkinson's disease (PD) is a chronic, degenerative brain disease characterized by muscle tremors, rigidity, and a paucity of muscle movement. Patients with PD frequently develop emotional disorders, the most common being depression. Some researchers have suggested that the onset of depression in PD patients is a natural consequence of impaired movement while others have suggested that the depression arises from changes in brain chemicals called neurotransmitters. A recent study of 105 patients with PD who attended the neurology clinic at the Johns Hopkins Hospital were examined for the presence of depression. Twenty one percent of the patients had evidence of major depression, 20 percent had signs of minor depression, and the rest were not depressed. They found no association between severity of parkinsonian symptoms and depression, but did find a significant correlation between depression and physical impairment. Depression was highest in the early and late stages of the disease. In the early stage of the disease patients with symptoms on their right side (left hemi-PD) tended to develop depression more frequently. The severity of depression could also be correlated to the dosage of l-dopa + decarboxylase the patient received for their parkinsonian symptoms. Late stage depression could be correlated with age and severity of impairment in activities of daily living. The patients with major depression also had poorer scores on a test of cognitive (intellectual) functioning. More research is needed to clarify the relationship between intellectual impairment and depression. This study suggests that there may be more than one cause of depression in PD patients and that depression might affect the course of the disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Parkinsonism

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Dementia of depression in Parkinson's disease and stroke

Article Abstract:

Depression is common in patients who have neurological illness. In the past, such depression was thought to be secondary to neurological illnesses such as Parkinson's disease (PD), but more recently research has shown that many depressed patients with neurological illnesses have biological precursors to depression. Similarly, while it has been assumed that intellectual deficits are secondary to neurological disorders, evidence suggests that this may not necessarily be the case. For instance, intellectual deficits are seen just as often early in the progression of PD as they are in later stages. In the present paper, it is hypothesized that affective disorders, such as depression, suffered by patients with neurological disorders are at least partially responsible for the intellectual impairment observed in these patients. In a review of the literature, evidence was found that associates significant intellectual impairment with depression following a stroke and with depression in PD patients. In both cases, major depression, a particularly severe form of affective disorder, was specifically associated with intellectual impairment; the intellectual profiles of these patients closely resembled the intellectual profiles of non-neurologically impaired patients with major depression. Therefore, the intellectual impairment seen in neurologically impaired patients may be a function of depression and subject to improvement with treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Parkinson's disease, Parkinson disease, Cognition disorders, Cognitive disorders

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Are depressive symptoms nonspecific in patients with acute stroke?

Article Abstract:

Patients with stroke often suffer from major depression. Studies have found evidence suggesting that this depression is similar to functional major depression (major depression without an organic cause.) It is unclear, however, whether the same diagnostic criteria for functional depression can be used to evaluate patients with stroke; medically ill patients often have symptoms characteristic of depression (such as changes in appetite, sleep, or sexual interest) that are physiological in origin. The present study evaluated 205 stroke patients to determine the characteristics of their major depression, when present, and to determine if patients with this condition could be effectively evaluated for depression by standard means. Patients were interviewed; psychiatrically and neurologically evaluated; and their depressive symptoms were categorized as either autonomic (physiological) or psychological in origin. Of the 205 patients, 85 had a depressed mood; and of these patients, 46 were diagnosed with major depression. The majority of these patients had physiological symptoms as well, suggesting that both physiological and psychological depressive symptoms are strongly associated with depression in stroke patients. Physiological symptoms were rarely present by themselves. Therefore, standard assessment scales, which usually measure psychological variables, are appropriate for use with stroke patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Identification and classification, Stroke patients

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