Pattern of Depressive Symptoms in Parkinson's Disease

Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, United States
Psychosomatics (Impact Factor: 1.86). 09/2009; 50(5):448-54. DOI: 10.1176/appi.psy.50.5.448
Source: PubMed


Depressive symptoms are common in Parkinson's disease (PD); however, it is unclear whether there are specific depressive symptom patterns in patients with PD and comorbid depression (dPD).
The goal of this study is to examine the frequency and correlates of specific depressive symptoms in PD.
A sample of 158 individuals with PD completed the self-rated Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS). By multiple-regression analysis, the authors examined the association between HANDS total and subscale scores and various demographic variables.
The frequency of depression was 37% (N=58). Patients with a history of depression before PD had significantly more serious depression than those who had no such history. Of those who were more depressed, the most common symptoms of depression endorsed were low energy, difficulty with concentration/making decisions, feeling blue, feeling hopeless, and having poor sleep.
There is a relatively high prevalence of dPD. Items on the HANDS that discriminated best between depressed and nondepressed subjects with PD included feeling blue, feeling hopeless, feeling worthless, lack of interest, and self-blame. It remains to be defined whether dPD should be understood primarily as a psychological reaction to a physical disability or perceived impending one, or as a direct expression of the neuropathology of PD.

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    • "Depression can negatively affect energy levels, concentration and decision making, sleep, and perceived quality of life (Farabaugh et al., 2009;Reijnders et al., 2008). Motor and cognitive performance are also negatively affected by depression in those with PD (Farabaugh et al., 2009). Since depression can jeopardize both the physical and emotional health of those suffering from PD, this study's findings of improvement in depression scores with adaptive yoga encourage further exploration of this topic. "
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    ABSTRACT: Parkinson's disease (PD) is a neurodegenerative disease that affects muscle tone, strength, flexibility, motor control, psychological outlook, cognition, and function. Exercise has been found to improve physical ability and psychological outlook, but the effect of yoga on individuals with PD has not been well researched. The purposes of this study were to identify outcome measures that were responsive to change in individuals with PD after an 8-week adaptive yoga program and to determine appropriate sample sizes for future studies. In a repeated measures design, 10 participants with a Hoehn and Yahr stage of 2 or 3 were tested prior to and after an 8-week control phase and again after they underwent an 8-week adaptive yoga program. Analysis of variance (ANOVA) tests revealed differences in time of measure that approached significance for the depression subscale of the Hospital Anxiety and Depression Scale (HADS) (p = 0.008) and the 30-Second Chair Stand (TSCS) (p = 0.013). The interaction between time of measure and gender approached significance for the Sit-and-Reach Test (SRT) (p = 0.08 and 0.03, right and left respectively), with male participants improving in sit-and-reach flexibility compared with female participants after intervention. The interaction between time of measure and age approached significance for the Single-Leg Balance test (SLB) (p = 0.007), with younger participants improving in SLB time after intervention. Power calculations found that a sample size ranging from 33 to 153 would be required to achieve significance at the 0.01 level in the various outcome measures in a future study of this design. The depression subscale of the HADS, the TSCS, the SLB, and the right and left SRT were the measures that changed following the yoga intervention and are recommended as outcome measures in future studies investigating the effectiveness of yoga for individuals with PD. This preliminary study supports further investigation of adaptive yoga using a randomized design and a larger sample size of individuals with PD.
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    • "As indicated on the CONSORT diagram (Figure 1), during check-in at the Cancer Institute, patients were approached by clinical psychology doctoral students and given the opportunity to complete the Harvard National Depression Screening scale (HANDS; Baer et al., 2000), a 10-item measure assessing core symptoms of major depression (DSM-IV; APA, 1994). The HANDS has been used with cancer patients (Hopko et al., 2008) and other samples of depressed medical patients (Farabaugh et al., 2009; Gonzalez et al., 2007). The HANDS has a score range of 0-30, with a cutpoint of 9 or greater having diagnostic sensitivity of 95% (Baer et al., 2000). "
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