Network for Medical Sciences, University of Stavanger, Stavanger, Norway.
Department of Research, Section of Biostatistics, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.
J Neurol. 2017 Dec;264(12):2401-2408. doi: 10.1007/s00415-017-8638-1. Epub 2017 Oct 14.
Depression is common in patients with Parkinson disease and causes suffering and increased caregiver burden. A better understanding of depressive symptoms in Parkinson disease, their progression, and risk factors may, therefore, benefit management of these patients. The present study included 187 drug-naïve patients with incident PD and 166 controls from the population-based Norwegian ParkWest project. Depressive symptoms were examined with the Montgomery and Aasberg Depression Rating Scale (MADRS) at time of diagnosis and inclusion in the study and after 1, 3, 5, and 7 years of follow-up. Associations between MADRS scores and risk factors were assessed using generalized estimating equations (GEE). The mean MADRS score from all 823 examinations during the study period was 4.2 in patients and 1.3 in 732 examinations among controls. Among controls, the occurrence of depressive symptoms was also lower and rather stable during follow-up, while in patients, we observed a decrease from time of diagnosis and until the 1-year visit, followed by a steady increase in these symptoms over time. Factors associated with higher MADRS score in the multivariable model were female sex, being dependent, higher pain score, higher Unified PD Rating Scale (UPDRS) motor score, and lower Mini-Mental State Examination (MMSE) score. The results from this study underscore the importance and frequency of depressive symptoms in patients with early PD. Furthermore, risk factors that may be considered PD-nonspecific are associated with depressive symptoms as are factors that reflect the progression of PD.
抑郁症在帕金森病患者中很常见，会导致患者痛苦和照顾者负担增加。因此，更好地了解帕金森病患者的抑郁症状、其进展和风险因素可能有助于这些患者的管理。本研究纳入了来自基于人群的挪威 ParkWest 项目的 187 例初发帕金森病患者和 166 例对照。在诊断时和研究纳入时以及随访 1、3、5 和 7 年后，使用蒙哥马利和阿斯伯格抑郁评定量表（MADRS）评估抑郁症状。使用广义估计方程（GEE）评估 MADRS 评分与风险因素之间的关联。在整个研究期间的 823 次检查中，患者的平均 MADRS 评分为 4.2，对照组的 732 次检查中为 1.3。在对照组中，抑郁症状的发生也较低且在随访期间相对稳定，而在患者中，我们观察到从诊断到 1 年就诊时症状逐渐减轻，随后这些症状逐渐加重。多变量模型中与 MADRS 评分较高相关的因素包括女性、依赖、更高的疼痛评分、更高的统一帕金森病评定量表（UPDRS）运动评分和更低的简易精神状态检查（MMSE）评分。这项研究的结果强调了早期帕金森病患者抑郁症状的重要性和频率。此外，与帕金森病相关的非特异性因素以及反映帕金森病进展的因素与抑郁症状相关。
