Faculty of Philology, University of Belgrade, Belgrade, Serbia.
Parkinsonism Relat Disord. 2012 May;18(4):339-42. doi: 10.1016/j.parkreldis.2011.11.020. Epub 2011 Dec 13.
Apathy and depression are among the most common psychiatric and behavioral disorders associated with Parkinson's disease (PD). The objective of this study was to examine the prevalence and demographic and clinical correlates of apathy and depression in a clinical population-based sample of patients with PD and to assess whether apathy may present as a primary behavioral disturbance independent from depression and cognitive impairment. A series of 360 PD patients underwent psychiatric investigation with the Starkstein's Apathy Scale (AS), and the 17-item Hamilton Depression Rating Scale (HDRS-17), motor scoring with Hoehn and Yahr (HY) staging, and the Unified Parkinson's Disease Rating Scale (UPDRS); and cognitive screening with the Mini-Mental State Examination (MMSE) on the same day. Apathy coexisted with depression in 133 (36.9%) of PD patients, compared with depression without apathy in 16 (4.4%), apathy without depression in 84 (23%), and neither apathy nor depression in 127 PD patients (35.2%). Apathy was associated with higher axial UPDRS impairment score, lower MMSE score, higher l-dopa dosage, and earlier HY stages, while depression was predicted by the more advanced HY stages and younger age of PD patients. These findings suggest that apathy and depression may be separable in PD, although both are common in patients with PD. Therefore these two conditions should be systematically screened and considered in the care and management of PD.
冷漠和抑郁是帕金森病（PD）最常见的精神和行为障碍之一。本研究的目的是在 PD 临床人群样本中检查冷漠和抑郁的患病率以及人口统计学和临床相关性，并评估冷漠是否可能表现为一种与抑郁和认知障碍无关的主要行为障碍。一系列 360 名 PD 患者接受了精神病学调查，使用 Starkstein 的冷漠量表（AS）和 17 项汉密尔顿抑郁评定量表（HDRS-17），运动评分使用 Hoehn 和 Yahr（HY）分期和统一帕金森病评定量表（UPDRS）；同一天还进行了认知筛查，使用简易精神状态检查（MMSE）。与 16 名（4.4%）无冷漠抑郁的 PD 患者相比，133 名（36.9%）PD 患者同时存在冷漠和抑郁，84 名（23%）患者有冷漠而无抑郁，127 名 PD 患者（35.2%）既无冷漠也无抑郁。冷漠与较高的轴向 UPDRS 损害评分、较低的 MMSE 评分、较高的左旋多巴剂量和更早的 HY 分期相关，而抑郁则由更晚期的 HY 分期和更年轻的 PD 患者年龄预测。这些发现表明，冷漠和抑郁在 PD 中可能是可分离的，尽管两者在 PD 患者中都很常见。因此，这两种情况应在 PD 的护理和管理中进行系统筛查和考虑。
