From the Department of Psychiatry (A.F.G.L., A.J.H.M.), Maastricht University Medical Center, Maastricht; School for Mental Health and Neuroscience (A.F.G.L., A.J.H.M., S.K.), Maastricht University, Maastricht, the Netherlands; Neurology and Movement Disorders Unit (K.D.), Lille University Medical Center, Lille, France; Mental Health Care Line (L.M.), Michael E. DeBakey Veterans Administration Medical Center and Departments of Psychiatry and Neurology, Baylor College of Medicine, Houston, TX; Alzheimer Disease Research Unit and CIBERNED (P.M.-M.), Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Madrid, Spain; Departments of Neurology and Psychiatry (I.H.R.), University of Rochester School of Medicine and Dentistry, Rochester, NY; and School of Psychiatry (S.E.S.), University of Western Australia and Fremantle Hospital, Fremantle, Australia.
Neurology. 2013 Sep 17;81(12):1036-43. doi: 10.1212/WNL.0b013e3182a4a503. Epub 2013 Aug 14.
To construct a model for depression in Parkinson disease (PD) and to study the relative contribution of PD-specific and nonspecific risk factors to this model.
Structural equation modeling of direct and indirect associations of risk factors with the latent depression outcome using a cross-sectional dataset of 342 patients with PD.
A model with acceptable fit was generated that explained 41% of the variance in depression. In the final model, 3 PD-specific variables (increased disease duration, more severe motor symptoms, the use of levodopa) and 6 nonspecific variables (female sex, history of anxiety and/or depression, family history of depression, worse functioning on activities of daily living, and worse cognitive status) were maintained and significantly associated with depression. Nonspecific risk factors had a 3-times-higher influence in the model than PD-specific risk factors.
In this cross-sectional study, we showed that nonspecific factors may be more prominent markers of depression than PD-specific factors. Accordingly, research on depression in PD should focus not only on factors associated with or specific for PD, but should also examine a wider scope of factors including general risk factors for depression, not specific for PD.
构建帕金森病（PD）抑郁模型，并研究 PD 特异性和非特异性风险因素对该模型的相对贡献。
使用横断面数据集对 342 例 PD 患者的潜在抑郁结果进行风险因素的直接和间接关联的结构方程建模。
生成了一个具有可接受拟合度的模型，解释了抑郁的 41%的方差。在最终模型中，保留了 3 个 PD 特异性变量（疾病持续时间增加、更严重的运动症状、左旋多巴的使用）和 6 个非特异性变量（女性、焦虑和/或抑郁史、抑郁症家族史、日常生活活动功能更差、认知状态更差），且与抑郁显著相关。非特异性风险因素对模型的影响是非特异性风险因素的 3 倍。
在这项横断面研究中，我们表明非特异性因素可能比 PD 特异性因素更能显著标记抑郁。因此，PD 抑郁的研究不仅应关注与 PD 相关或特异性的因素，还应研究包括一般抑郁风险因素在内的更广泛的因素，而不是 PD 特异性因素。
