Perrin Andrew J, Nosova Ekaterina, Co Kim, Book Adam, Iu Oscar, Silva Vanessa, Thompson Christina, McKeown Martin J, Stoessl A Jon, Farrer Matthew J, Appel-Cresswell Silke
Research Track Residency, Department of Psychiatry, University of British Columbia, Vancouver, BC V5Z 1M9, Canada; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 2B5, Canada.
Djavad Mowafaghian Centre for Brain Health, Department of Medical Genetics, University of British Columbia, Vancouver, BC V6T 2B5, Canada.
Parkinsonism Relat Disord. 2017 Mar;36:93-97. doi: 10.1016/j.parkreldis.2016.12.026. Epub 2016 Dec 29.
30-40% of patients with Parkinson's disease (PD) experience depression during their illness; identifying subtypes of depression and groups at risk remains a challenge in routine clinical care. One avenue that remains underexplored is the gender-specific profiles manifested in PD depression. We sought to explore this in a large sample of clinical PD patients.
307 patient records at a tertiary referral centre were reviewed for clinical and demographic factors. We used recursive partitioning to determine which items on the Beck Depression Inventory (BDI) were most useful in differentiating patients who scored in the depressed range (≥14) from those who scored in the non-depressed range (≤13). We also used recursive partitioning to identify those BDI items that were most effective in differentiating depressed from non-depressed patients in both genders.
We were able to identify a subset of items on the BDI that were most useful in partitioning depressed from non-depressed in the entire cohort. Partitioning of men and women with PD depression relied on different key BDI items, melancholy featuring prominently in women, while the more classical factors associated with depression in PD (apathy and loss of libido) featured more prominently in men.
Unique factors not previously identified as core features of depression in PD were found most useful in partitioning depressed women from non-depressed women. This raises the possibility that a female-specific depressive profile has been under-appreciated in past work. Additional studies are required to discern how this may impact future research, diagnosis and treatment.
30%至40%的帕金森病（PD）患者在患病期间会出现抑郁；在常规临床护理中，识别抑郁亚型和高危群体仍然是一项挑战。一个尚未充分探索的途径是PD抑郁中表现出的性别特异性特征。我们试图在大量临床PD患者样本中对此进行探索。
回顾了一家三级转诊中心的307份患者记录，以获取临床和人口统计学因素。我们使用递归划分来确定贝克抑郁量表（BDI）上哪些项目最有助于区分抑郁评分范围（≥14）的患者和非抑郁评分范围（≤13）的患者。我们还使用递归划分来识别那些在区分男女抑郁患者和非抑郁患者方面最有效的BDI项目。
我们能够在BDI上识别出一组项目，这些项目在区分整个队列中的抑郁患者和非抑郁患者方面最有用。PD抑郁男性和女性的划分依赖于不同的关键BDI项目，忧郁在女性中更为突出，而与PD抑郁相关的更经典因素（冷漠和性欲减退）在男性中更为突出。
以前未被确定为PD抑郁核心特征的独特因素被发现对区分抑郁女性和非抑郁女性最有用。这增加了一种可能性，即女性特异性抑郁特征在过去的研究中未得到充分重视。需要进一步的研究来了解这可能如何影响未来的研究、诊断和治疗。
