Department of Neurology, Mayo Clinic, Jacksonville, Florida 32224, USA.
Can J Neurol Sci. 2010 Jan;37(1):61-6. doi: 10.1017/s0317167100009665.
To examine predictive factors associated with onset of depression among individuals diagnosed with Parkinson's disease (PD).
Depression may precede or follow symptomatic parkinsonism in PD. It is frequently treatable but often overlooked.
The clinical series comprised 685 individuals who were diagnosed with PD and followed by one neurologist (RJU) from 1994 to 2007. The primary outcome was time to depression following the onset of PD. Diagnosis of depression was based on clinical assessment of depressive symptoms from patients (and spouse/family/caregiver) and antidepressant usage. A number of demographic, historical and clinical predictive factors were examined, including gender, age at symptomatic onset, disease duration, onset characteristics, clinical ratings, antiparkinsonian medications, cognitive status, depression history, and familial history of PD and other neurodegenerative disorders.
Seventy-two percent of patients developed depression within ten years of symptomatic PD onset, and the mean time to depression was 7.9 years (median: 5.7 years). Factors associated with depression included longer PD duration, greater impairment in activities of daily living, and positive family history of motor neuron disease (MND).
A high rate of individuals with PD develop depressive symptoms during the course of the disease. Based on first clinic visit characteristics, most factors examined were not helpful in identifying individuals with an increased risk of depression. However, disease duration, functional limitations and family history of MND should lead clinicians to an increased vigilance for identifying depression.
探讨与帕金森病（PD）患者抑郁发作相关的预测因素。
抑郁可能先于或后于 PD 的运动症状出现。它通常可以治疗，但经常被忽视。
该临床系列包括 685 名于 1994 年至 2007 年期间被一位神经科医生（RJU）诊断为 PD 并进行随访的患者。主要结局是 PD 发病后出现抑郁的时间。抑郁的诊断基于患者（及其配偶/家人/护理人员）的临床评估的抑郁症状和抗抑郁药物的使用情况。检查了许多人口统计学、历史和临床预测因素，包括性别、症状发作时的年龄、疾病持续时间、发病特征、临床评分、抗帕金森病药物、认知状态、抑郁史以及 PD 和其他神经退行性疾病的家族史。
72%的患者在 PD 症状发作后十年内出现抑郁，抑郁的平均时间为 7.9 年（中位数：5.7 年）。与抑郁相关的因素包括 PD 持续时间较长、日常生活活动能力受损更严重，以及运动神经元病（MND）的阳性家族史。
相当一部分 PD 患者在疾病过程中会出现抑郁症状。根据首次就诊的特征，大多数检查的因素对识别有较高抑郁风险的个体并没有帮助。然而，疾病持续时间、功能限制和 MND 的家族史应促使临床医生提高对识别抑郁的警惕性。
