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Depression in Parkinson disease: a disabling but neglected factor

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Abstract

20 depressed and 20 non depressed patients with Parkinson disease were rated for disability on the Northwestern University Disability Scale and for severity of the “typical” motor symptoms on the Columbia University Rating Scale and were assessed for mental deterioration. The severity of the “typical” symptoms was practically equivalent in the two groups but the depressed patients not only presented mild mental deterioration but were significantly more disabled (less independent) than the patients without depression. A significant correlation was found between severity of depression and degree of disability but not between severity of depression and severity of “typical” motor symptoms. Depression was diagnosed much later than the “typical” symptoms. Only 25% of the depressed parkinsonians had received tricyclic antidepressants, about 20% had been treated with dopamine-antagonist psychotropic drugs and some 50% had received no treatment at all against depression. Timely diagnosis and appropriate treatment of depression in parkinsonian patients limits the effects of a major disabling factor.

Sommario

A 20 parkinsoniani depressi ed a 20 parkinsoniani non depressi sono state applicate scale di valutazione della disabilità (Northwestern University Disability Scale o NUDS) e della severità dei sintomi motori “tipici” (Columbia University Rating Scale o CURS). Nei due gruppi è stata anche valutata l'eventuale presenza di decadimento intellettivo.

I risultati hanno dimostrato che, mentre la severità dei sintomi “tipici” è praticamente sovrapponibile nei due gruppi, i soggetti depressi, oltre a presentare un lieve grado di decadimento intellettivo, sono significativamente più disabili (meno autonomi) dei pazienti senza depressione. Correlazione significativa è stata trovata tra gravità dei sintomi depressivi ed aumento della disabilità. Nessuna correlazione si è potuta evidenziare tra la severità dei sintomi depressivi e quella dei sintomi motori “tipici”.

Nella popolazione esaminata, i sintomi depressivi sono stati riconosciuti con significativo ritardo rispetto a quelli “tipici”. Solo il 25% dei parkinsoniani depressi ha ricevuto trattamento con triciclici; il 207% circa è stato trattato con psicofarmaci dopamino-antagonisti; il 50% circa non si è visto prescrivere alcuna terapia antidepressiva.

Riconoscere e trattare adeguatamente i sintomi depressivi nel parkinsoniano consente di limitare gli effetti di un importante fattore di disabilità.

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References

  1. Andersen J., Aabro E., Gulmann N., Hjelmsted A. andPedersen H.E.:Antidepressive treatment in Parkinson's disease. Acta Neurol Scand 62: 210–219, 1980.

    Article  PubMed  CAS  Google Scholar 

  2. Baldessarini R.J.:Drugs and the treatment of psychiatric disorders. Tricyclic antidepressants. In Goodman Gilman A., Goodman L.S., Gilman A. eds.: The Pharmacological Basis of Therapeutics. McMillan, New York: 418–427; 1980.

    Google Scholar 

  3. Barbeau A.:L-DOPA therapy in Parkinson's disease: a critical review of nine years' experience. Can Med Ass J 101: 791–800, 1969.

    Google Scholar 

  4. Beck A.T., Ward C.H., Mendelson M., Mock J., Erbaugh J.:An inventory for measuring depression. Arch Gen Psychiat 4: 561–571, 1961.

    PubMed  CAS  Google Scholar 

  5. Blessed G., Tomlinson B.E. andRoth M.:The association between quantitative measures of dementia and of senile change in the cerebral gray matter of elderly subjects. Brit J Psychiat 114: 797–811, 1968.

    PubMed  CAS  Google Scholar 

  6. Botez M.I., Barbeau A.:Long term mental changes in levodopa treated patients. Lancet 2: 1028–9, 1973.

    PubMed  CAS  Google Scholar 

  7. Brown G.L., Wilson W.P.:Parkinsonism and depression. South Med J 65: 540–545, 1972.

    PubMed  CAS  Google Scholar 

  8. Canter G.J., de laTorre R., Mier M.A.:A method for evaluating disability in patients with Parkinson disease. J. Nerv Ment Dis 133: 143–147, 1961.

    Article  PubMed  CAS  Google Scholar 

  9. Celesia G.C., Wanamaker W.M.:Psychiatric disturbances in Parkinson's disease. Dis Nerv Syst 33: 577–583, 1972.

    PubMed  CAS  Google Scholar 

  10. Cherington M.:Parkinsonism, l-dopa and mental depression. J. Am. Geriatr Soc 18: 513–516, 1970.

    PubMed  CAS  Google Scholar 

  11. Conti L., Stocchi F., Martucci N., Ruggieri S., Bruno G., Agnoli A.:Discussione sul problema della demenza e depressione nel morbo di Parkinson. In Agnoli A., Bertolani G. eds Atti della VIII Riunione della L.I.M.P.E. Guanella, Roma pp. 271–285. 1982.

    Google Scholar 

  12. Damasio A.R., Lobo Antunes J., Macedo C.:L-dopa, Parkinsonism and Depression. Lancet, 2: 611–612, 1970.

    PubMed  CAS  Google Scholar 

  13. Diamond S.G., Markham C.H.:Evaluating the evaluations: or how to weigh the scales of parkinsonian disability. Neurology (Cleveland) 33: 1098–1099, 1983.

    CAS  Google Scholar 

  14. Duvoisin R.C.:The evaluation of Extrapyramidal disease. In: de Ajuriaguerra J., Gauthier G. eds. Monoamines, noyaux gris centraux et syndrome de Parkinson. Masson, Paris, pp. 313–325, 1971.

    Google Scholar 

  15. Folstein M.F., Folstein S.E., McHugh P.R.: “Mini-mental state”, a practical method for grading the cognitive state of patients for the clinician. J. Psychiat Res 12: 189–198, 1975.

    PubMed  CAS  Google Scholar 

  16. Folstein M.F., McHugh P.R.:Dementia syndrome of depression. In: Katzman R., Terry R.D., Bick K.L. eds Alzheimer's disease: senile dementia and related disorders. “Aging” Vol 7, Raven Press, New York, pp. 87–93, 1978.

    Google Scholar 

  17. Hamilton M.:A Rating Scale for Depression. J Neurol Neurosurg Psychiat 23: 56–62, 1960.

    PubMed  CAS  Google Scholar 

  18. Horn S.:Some psychological factors in parkinsonism. J Neurol Neurosurg Psychiat 37: 27–31, 1974.

    PubMed  CAS  Google Scholar 

  19. Jenkins R.B., Groh R.H.:Mental Symptoms in parkinsonian patients treated with l-dopa. Lancet 2: 177–180, 1970.

    PubMed  CAS  Google Scholar 

  20. Lieberman A., Dziatolowski M., Kupersmith M. et al:Dementia in Parkinson disease. Ann Neurol 6: 355–359, 1979.

    PubMed  CAS  Google Scholar 

  21. Marsh G.G., Markham C.H.:Does levodopa alter depression and psychopathology in Parkinsonian patients? J Neurol Neurosurg Psychiat 36: 925–935. 1973.

    Article  PubMed  CAS  Google Scholar 

  22. Mastrosimone F., De Angelis G., Iaccarino C., Vizioli R.:Approccio terapeutico al tremore parkinsoniano. In: Agnoli A., Bertolani G. eds Atti della IX Riunione della L.I.M.P.E. Guanella, Roma pp. 215–220, 1983.

    Google Scholar 

  23. Mayeux R., Stern Y., Rosen J., Leventhal J.:Depression, intellectual impairment and Parkinson disease. Neurology (Ny) 31: 645–650, 1981.

    CAS  Google Scholar 

  24. McHugh P.R., Folstein M.F.:Psychopathology of dementia: implications for neuropathology. In: Katzman R. ed. Congenital and acquired cognitive disorders. Raven Press, New York, pp. 17–30, 1979.

    Google Scholar 

  25. Mindham R.H.S.:Psychiatric symptoms in parkinsonism. J Neurol Neurosurg Psychiat 33: 188–191, 1970.

    PubMed  CAS  Google Scholar 

  26. Mindham R.H.S., Marsden C.D., Parkes J.D.:Psychiatric symptoms during l-dopa therapy for Parkinson's disease and their relationship to physical disability. Psychol Med 6: 23–33, 1976.

    Article  PubMed  CAS  Google Scholar 

  27. Nardini M., Passero S., Nitti M., Bonelli G., et al:Studio clinico della depressione in corso di morbo di Parkinson. In: Agnoli A., Bertolani G. eds Atti della VIII Riunione della L.I.M.P.E. Guanella, Roma, pp. 32–41, 1982.

    Google Scholar 

  28. Parkinson J.:An essay on the shaking palsy (1817). In: Critchley M. James Parkinson (1755–1824). McMillan, London, 1955.

    Google Scholar 

  29. Perrone P., Porazzi D., Ricotta E., Rovetta P.:Osservazione sull'azione dei timolettici triciclici in fasi diverse del trattamento della malattia di Parkinson. In: Agnoli A., Bertolani G. eds Atti della IX Riunione della L.I.M.P.E. Guanella. Roma, pp. 279–283, 1983.

    Google Scholar 

  30. Robins A.H.:Depression in patients with Parkinsonism. Br J Psychiat 128: 141–145, 1976.

    Article  CAS  Google Scholar 

  31. Schwab J., Bialow M., Clemmons R., Martin P., Holzer C.:The Beck Depression Inventory with medical inpatients. Acta Psychiat Scand 43: 255–266, 1967.

    PubMed  CAS  Google Scholar 

  32. Sigwald J., Bouttier D., Raymondeaud C.L., Marquez M., Gal J.C.:Etude de l'action sur l'akinésie parkinsonienne de deux derivés de l'iminodibenzyle: le chlorhydrate de N-(gamma dimethyl-aminopropyl)-iminodibenzyle ou imipramine et le [beta(hydroxyéthyl-4-piperazinyl)-3-propyl]-5 iminodibenzyle ou 8307 RP. Presse Méd 67: 1697–1698, 1959.

    Google Scholar 

  33. Strang R.R.:Imipramine in the treatment of Parkinsonism, a double-blind placebo study. Br Med J 2: 33–34, 1965.

    Article  PubMed  CAS  Google Scholar 

  34. Sweet R.D., McDowell F.H., Feiguson J.S., Loranger A.W., Goodell H.:Mental symptoms in Parkinson's disease during chronic treatment with levodopa. Neurology (Minneap) 26: 305–310, 1976.

    CAS  Google Scholar 

  35. Warburton J.W.:Depressive symptoms in Parkinson patients referred for thalamotomy. J Neurol Neurosurg Psychiat 30: 368–370, 1967.

    PubMed  CAS  Google Scholar 

  36. Yahr M.D., Duvoisin R.C., Schear M.J., Barrett R.E. andHoehn M.M.:Treatment of parkinsonism with levodopa. Arch Neurol 21: 343–354, 1969.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. I Clinica Neurologica dell'Università, Torino

    Cantello R. & Riccio A.

  2. III Clinica Neurologica dell'Università, Torino

    Scarzella L., Leotta D. & Bergamasco B.

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  1. Cantello R.
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  2. Riccio A.
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  3. Scarzella L.
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  4. Leotta D.
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  5. Bergamasco B.
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Party supported by Regione Piemonte, grant n. 17

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Cantello, R., Riccio, A., Scarzella, L. et al. Depression in Parkinson disease: a disabling but neglected factor. Ital J Neuro Sci 5, 417–422 (1984). https://doi.org/10.1007/BF02042626

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