Dogan Bilge, Akyol Ali, Memis Cagdas O, Sair Ahmet, Akyildiz Utku, Sevincok Levent
Department of Psychiatry, Adnan Menderes University, Aydin, Turkey.
Department of Neurology, Adnan Menderes University, Aydin, Turkey.
Psychogeriatrics. 2019 Jan;19(1):73-79. doi: 10.1111/psyg.12366. Epub 2018 Aug 23.
The risk factors for depressive symptoms in patients with Parkinson's disease (PD) under dopaminergic drug treatment are unclear. In this study, we examined whether some temperament traits are related to the presence of comorbid depression in PD patients, independent of the characteristics of illness and drug treatment.
The participants in this study were 74 patients with idiopathic PD who were already treated with stable doses of levodopa or dopamine agonists. Depressive (n = 20) and non-depressive (n = 52) PD patients were assessed by means of the Unified Parkinson's Disease Rating Scale, Beck Depression Inventory, and Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire. The doses of levodopa and dopamine agonists were converted into levodopa equivalent daily dose.
The duration of treatment in the depressive group was significantly longer than in the non-depressive group (P = 0.03). The depressive patients had significantly higher scores on the Unified Parkinson's Disease Rating Scale than the non-depressive patients. Depressive (P < 0.0001), cyclothymic (P < 0.0001), anxious (P < 0.0001), and irritable (P = 0.02) temperament scores were significantly higher in depressive than in non-depressive patients. Hyperthymia scores were significantly higher in non-depressive patients than in depressive patients (P = 0.01). Logistic regression analysis revealed that depressive temperament traits (P = 0.03) significantly predicted the diagnosis of depression. In contrast, hyperthymic temperament seemed to be associated with the absence of depression (P = 0.006).
Our results indicated that the severity of PD and duration of dopaminergic treatment were not predictive of the development of depression in PD patients. Depressive temperament strongly predicted the development of depression in our sample. Hyperthymic temperament seemed to be associated with patients without depression. We suggest that depressive temperament traits seem to be related to depression, while hyperthymic temperament may have a protective role in the risk of depression in PD patients.
多巴胺能药物治疗下帕金森病(PD)患者抑郁症状的风险因素尚不清楚。在本研究中,我们探讨了一些气质特征是否与PD患者共病抑郁的存在相关,而独立于疾病特征和药物治疗。
本研究的参与者为74例特发性PD患者,他们已接受稳定剂量的左旋多巴或多巴胺激动剂治疗。通过统一帕金森病评定量表、贝克抑郁量表和孟菲斯、比萨、巴黎和圣地亚哥自动问卷气质评估对抑郁(n = 20)和非抑郁(n = 52)的PD患者进行评估。将左旋多巴和多巴胺激动剂的剂量换算为左旋多巴等效日剂量。
抑郁组的治疗时间显著长于非抑郁组(P = 0.03)。抑郁患者在统一帕金森病评定量表上的得分显著高于非抑郁患者。抑郁患者的抑郁(P < 0.0001)、环性心境(P < 0.0001)、焦虑(P < 0.0001)和易怒(P = 0.02)气质得分显著高于非抑郁患者。非抑郁患者的情感高涨得分显著高于抑郁患者(P = 0.01)。逻辑回归分析显示,抑郁气质特征(P = 0.03)显著预测抑郁诊断。相比之下,情感高涨气质似乎与无抑郁相关(P = 0.006)。
我们的结果表明,PD的严重程度和多巴胺能治疗的持续时间不能预测PD患者抑郁的发生。在我们的样本中,抑郁气质强烈预测抑郁的发生。情感高涨气质似乎与无抑郁的患者相关。我们认为,抑郁气质特征似乎与抑郁有关,而情感高涨气质可能对PD患者的抑郁风险具有保护作用。