Psychopathological Symptoms of Depression in Parkinson’s Disease Compared to Major Depression

Abstract

Parkinson’s disease is frequently associated with depressive symptoms. When depression occurs at early stages and before the onset of characteristic motor symptoms of the disease, differential diagnosis of major depression may be difficult. Differences in psychopathological features of depression in Parkinson’s disease and major depression have been reported by some authors. This study presents data of 49 patients with depression in Parkinson’s disease and 38 patients with major depression. The severity of depressive symptoms was equivalent in both groups. Depressive features did not differ between the two groups with exception of affective flattening, delusional ideas and suicide attempts. In conclusion, this investigation gives support to the assumption of a common neurobiological origin of depression in Parkinson’s disease and major depression.

Suicide and suicidal ideation in Parkinson's disease

“…However, Brown et al [15] suggested that depressed PD patients had relatively common suicidal ideation, but reduced frequency of completed suicide. Merschdorf et al [37] studied differences in psychopathological features of depression in PD and major depression, and recorded the same prevalence of suicidal thoughts (76%) in both groups. However, suicide attempts were observed in 42% of psychiatric patients with major depression and only 4% of depressed PD patients (p < 0.001).…”

Depressive symptom profile in Parkinson's disease: a comparison with depression in elderly patients without Parkinson's disease

“…Two studies have directly compared the depressive symptom pattern in PD and non-PD cohorts (Erdal, 2001;Merschdorf et al, 2003). Merschdorf et al compared 49 hospitalized depressed patients with PD with 38 patients hospitalized with major depression (Merschdorf et al, 2003).…”

“…Merschdorf et al compared 49 hospitalized depressed patients with PD with 38 patients hospitalized with major depression (Merschdorf et al, 2003). Inner restlessness and irritability was somewhat more common in depressed PD patients than in non-PD patients with MD, whereas a significantly higher proportion of non-PD patients had flattening of affect, delusions, and attempted suicide.…”

“…Some authors have reported distinctive characteristics in PD related depression with less classical 'endogenous' depressive symptoms such as feelings of guilt, suicidal ideation, but more somatic symptoms such as anxiety, sleep disturbances and concentration difficulties (Gotham et al, 1986;Schiffer et al, 1988;Starkstein et al, 1990;Ehmann et al, 1990;Erdal, 2001;Merschdorf et al, 2003). However, few studies have directly compared depressive symptoms in patients with and without PD.…”

Brainstem pathology and non-motor symptoms in PD

“…Supporting the endogenous origin, some studies have shown a higher frequency and severity of depression in patients with PD than in other chronically disabling disorders [106][107][108]. In addition, a small percentage of PD patients show depression much before the onset of the motor symptoms [105,[109][110][111][112][113].…”