Gotham A M, Brown R G, Marsden C D
J Neurol Neurosurg Psychiatry. 1986 Apr;49(4):381-9. doi: 10.1136/jnnp.49.4.381.
Depression is a common feature of Parkinson's disease, a fact of both clinical and theoretical significance. Assessment of depression in Parkinson's disease is complicated by overlapping symptomatology in the two conditions, making global assessments based on observer or self-ratings of doubtful validity. The present study aimed to provide both a quantitative and qualitative description of the nature of the depressive changes found in Parkinson's disease as compared with normal elderly subjects and arthritis patients. As with previous studies, the patients with Parkinson's disease scored significantly higher than normal controls on various self-ratings of depression and anxiety but, in this study, did not differ from those with arthritis. Qualitatively, both the Parkinson's disease and the arthritis groups had depression characterised by pessimism and hopelessness, decreased motivation and drive, and increased concern with health. In contrast, the negative affective feelings of guilt, self-blame and worthlessness were absent in both patient groups. This pattern of depression was significantly associated with severity of illness and functional disability. However, these factors account for only a modest proportion of the variability in test scores. Probable unexplored factors are individual differences in coping style and availability of support.
抑郁症是帕金森病的一个常见特征，这一事实具有临床和理论双重意义。帕金森病患者的抑郁症评估因两种病症症状重叠而变得复杂，这使得基于观察者或自我评分的整体评估的有效性存疑。本研究旨在对帕金森病患者与正常老年受试者及关节炎患者相比所发现的抑郁变化的性质进行定量和定性描述。与先前的研究一样，帕金森病患者在各种抑郁和焦虑自我评分上的得分显著高于正常对照组，但在本研究中，他们与关节炎患者并无差异。从定性角度来看，帕金森病组和关节炎组的抑郁症都表现为悲观和绝望、动力和干劲下降以及对健康的担忧增加。相比之下，两个患者组均不存在内疚、自责和无价值感等负面情感。这种抑郁模式与疾病严重程度和功能残疾显著相关。然而，这些因素仅占测试分数变异性的一小部分。可能未被探究的因素是应对方式的个体差异和支持的可获得性。
