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The natural history of depressive symptoms in patients with incident Parkinson’s disease: a prospective cohort study

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Abstract

Depression is common in patients with Parkinson disease and causes suffering and increased caregiver burden. A better understanding of depressive symptoms in Parkinson disease, their progression, and risk factors may, therefore, benefit management of these patients. The present study included 187 drug-naïve patients with incident PD and 166 controls from the population-based Norwegian ParkWest project. Depressive symptoms were examined with the Montgomery and Aasberg Depression Rating Scale (MADRS) at time of diagnosis and inclusion in the study and after 1, 3, 5, and 7 years of follow-up. Associations between MADRS scores and risk factors were assessed using generalized estimating equations (GEE). The mean MADRS score from all 823 examinations during the study period was 4.2 in patients and 1.3 in 732 examinations among controls. Among controls, the occurrence of depressive symptoms was also lower and rather stable during follow-up, while in patients, we observed a decrease from time of diagnosis and until the 1-year visit, followed by a steady increase in these symptoms over time. Factors associated with higher MADRS score in the multivariable model were female sex, being dependent, higher pain score, higher Unified PD Rating Scale (UPDRS) motor score, and lower Mini-Mental State Examination (MMSE) score. The results from this study underscore the importance and frequency of depressive symptoms in patients with early PD. Furthermore, risk factors that may be considered PD-nonspecific are associated with depressive symptoms as are factors that reflect the progression of PD.

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Acknowledgements

The authors are grateful to all participants and the personnel involved in planning and conducting the Norwegian ParkWest study.

Author information

Author notes

  1. Jan Petter Larsen and Ingvild Dalen contributed equally to the manuscript.

Authors and Affiliations

  1. Network for Medical Sciences, University of Stavanger, Stavanger, Norway

    Jan Petter Larsen

  2. Department of Research, Section of Biostatistics, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway

    Ingvild Dalen

  3. Department of Neurology, Stavanger University Hospital, Stavanger, Norway

    Kenn Freddy Pedersen

  4. The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway

    Kenn Freddy Pedersen

  5. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Ole-Bjørn Tysnes

  6. Department of Neurology, Haukeland University Hospital, Bergen, Norway

    Ole-Bjørn Tysnes

Authors
  1. Jan Petter Larsen
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  2. Ingvild Dalen
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  3. Kenn Freddy Pedersen
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  4. Ole-Bjørn Tysnes
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Corresponding author

Correspondence to Ingvild Dalen.

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Ethical standards

The study was approved by the Regional Committee for Medical and Health Research Ethics, Western Norway. Signed written consent was obtained from all participants.

Conflicts of interest

OBT has been invited speaker for GSK, Orion Pharma, Pfizer, UCB, Novartis and Lundbeck and has participated in an advisory board for Lundbeck. JPL, ID, and KFP declare that they have no conflict of interest.

Funding

The Norwegian ParkWest study was supported by Grant #9111218 from the Western Norway Regional Health Authority, Grant #177966 from the Research Council of Norway, and the Norwegian Parkinson’s Disease Association.

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Larsen, J.P., Dalen, I., Pedersen, K.F. et al. The natural history of depressive symptoms in patients with incident Parkinson’s disease: a prospective cohort study. J Neurol 264, 2401–2408 (2017). https://doi.org/10.1007/s00415-017-8638-1

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  • DOI: https://doi.org/10.1007/s00415-017-8638-1

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