Starkstein S E, Preziosi T J, Bolduc P L, Robinson R G
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Nerv Ment Dis. 1990 Jan;178(1):27-31. doi: 10.1097/00005053-199001000-00005.
A consecutive series of 105 outpatients with Parkinson's disease (PD) were examined for the presence of depression. Twenty-one percent met diagnostic criteria for major depression, 20% had minor depression, and the remainder were not depressed. The frequency of depression showed a bimodal distribution over time, with highest frequencies occurring in the early and late stages of the disease. Although other factors such as a positive family history of psychiatric disorders, quality of social functioning, and severity of tremor, rigidity, and akinesia did not show a significant association with depression, depressed patients had significantly higher impairment scores in activities of daily living and cognitive function than nondepressed PD patients. There was also a significant correlation between impairment and depression scores. In addition, among patients with mainly unilateral symptoms, depression was significantly associated with greater left hemisphere involvement. These findings suggest that depression in the early stages of the disease may be related to left hemisphere dysfunction, while later in the disease, depression and impairment in activities of daily living are interrelated. This may indicate more than one etiology of depression or that depression may have an adverse impact on the course of the disease.
对连续的105例帕金森病（PD）门诊患者进行了抑郁检查。21%符合重度抑郁的诊断标准，20%有轻度抑郁，其余患者无抑郁。抑郁的发生率随时间呈双峰分布，在疾病的早期和晚期发生率最高。尽管其他因素，如精神障碍的阳性家族史、社会功能质量以及震颤、强直和运动不能的严重程度与抑郁无显著关联，但抑郁患者在日常生活活动和认知功能方面的损伤评分显著高于非抑郁的PD患者。损伤与抑郁评分之间也存在显著相关性。此外，在主要表现为单侧症状的患者中，抑郁与左半球受累程度更大显著相关。这些发现表明，疾病早期的抑郁可能与左半球功能障碍有关，而在疾病后期，抑郁与日常生活活动损伤相互关联。这可能表明抑郁有多种病因，或者抑郁可能对疾病进程产生不利影响。
