Tags

Type your tag names separated by a space and hit enter

Beyond the iron mask: towards better recognition and treatment of depression associated with Parkinson's disease.
Mov Disord. 2002 May; 17(3):445-54.MD

Abstract

This review examines the frequency of depression complicating Parkinson's disease (PD), its aetiology and clinical features, and also how it may be recognised and treated. Studies investigating the frequency of depression in PD have yielded figures ranging between 2.7% and 70%. Methodological differences account for much of the disparity. The aetiology of depression in PD is complex, and probably relates to both biological and exogenous factors. Dysfunction of multiple neurotransmitter systems, including the serotonergic system, may be involved. Mood disturbances resulting from deep brain stimulation of the subthalamic nucleus may provide a fruitful area for future research, and assist our understanding of the neural networks involved in mediating depression. Several recent studies have confirmed that depression in the PD patient is a major determinant of quality of life and that this is closely related to dysfunction in other clinically important health areas. The validity for many existing scales in the screening, diagnosis, and monitoring of depression in the PD patient has not been established. The Montgomery-Asberg Depression Rating Scale and the Hamilton Rating Scale for Depression appear to have good diagnostic sensitivity and specificity when compared with DSM-IV criteria. Recommendations for the optimal drug treatment of depression in PD are difficult to give, due to an inexplicable dearth of sizeable, placebo-controlled studies. A majority of physicians would probably now opt for a selective serotonin reuptake inhibitor in the depressed PD patient. There is no good evidence that these drugs are associated with a worsening of motor features, but they should probably not be coprescribed with selegiline, because of the risk of causing a potentially serious serotonin syndrome. Several studies have suggested that depression in the PD patient is associated with a more rapid deterioration in cognitive and motor functions, perhaps as a surrogate marker for more extensive brainstem cell loss.

Authors+Show Affiliations

Neurology, Regional Neurosciences Centre, Newcastle General Hospital, and University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom. d.j.burn@ncl.ac.uk

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12112190

Citation

Burn, David J.. "Beyond the Iron Mask: Towards Better Recognition and Treatment of Depression Associated With Parkinson's Disease." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 17, no. 3, 2002, pp. 445-54.
Burn DJ. Beyond the iron mask: towards better recognition and treatment of depression associated with Parkinson's disease. Mov Disord. 2002;17(3):445-54.
Burn, D. J. (2002). Beyond the iron mask: towards better recognition and treatment of depression associated with Parkinson's disease. Movement Disorders : Official Journal of the Movement Disorder Society, 17(3), 445-54.
Burn DJ. Beyond the Iron Mask: Towards Better Recognition and Treatment of Depression Associated With Parkinson's Disease. Mov Disord. 2002;17(3):445-54. PubMed PMID: 12112190.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Beyond the iron mask: towards better recognition and treatment of depression associated with Parkinson's disease. A1 - Burn,David J, PY - 2002/7/12/pubmed PY - 2002/9/17/medline PY - 2002/7/12/entrez SP - 445 EP - 54 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 17 IS - 3 N2 - This review examines the frequency of depression complicating Parkinson's disease (PD), its aetiology and clinical features, and also how it may be recognised and treated. Studies investigating the frequency of depression in PD have yielded figures ranging between 2.7% and 70%. Methodological differences account for much of the disparity. The aetiology of depression in PD is complex, and probably relates to both biological and exogenous factors. Dysfunction of multiple neurotransmitter systems, including the serotonergic system, may be involved. Mood disturbances resulting from deep brain stimulation of the subthalamic nucleus may provide a fruitful area for future research, and assist our understanding of the neural networks involved in mediating depression. Several recent studies have confirmed that depression in the PD patient is a major determinant of quality of life and that this is closely related to dysfunction in other clinically important health areas. The validity for many existing scales in the screening, diagnosis, and monitoring of depression in the PD patient has not been established. The Montgomery-Asberg Depression Rating Scale and the Hamilton Rating Scale for Depression appear to have good diagnostic sensitivity and specificity when compared with DSM-IV criteria. Recommendations for the optimal drug treatment of depression in PD are difficult to give, due to an inexplicable dearth of sizeable, placebo-controlled studies. A majority of physicians would probably now opt for a selective serotonin reuptake inhibitor in the depressed PD patient. There is no good evidence that these drugs are associated with a worsening of motor features, but they should probably not be coprescribed with selegiline, because of the risk of causing a potentially serious serotonin syndrome. Several studies have suggested that depression in the PD patient is associated with a more rapid deterioration in cognitive and motor functions, perhaps as a surrogate marker for more extensive brainstem cell loss. SN - 0885-3185 UR - https://www.unboundmedicine.com/medline/citation/12112190/Beyond_the_iron_mask:_towards_better_recognition_and_treatment_of_depression_associated_with_Parkinson's_disease_ L2 - https://doi.org/10.1002/mds.10114 DB - PRIME DP - Unbound Medicine ER -