Validating screening tools for depression in Parkinson's disease

Kadhim, Sandra; Pringsheim, Tamara; Le, Anne; Fiest, Kirsten M.; Patten, Scott B.; Prisnie, Joey C.; Gill, Stephanie; Bulloch, Andrew G. M.; Hu, Bin

doi:10.1002/mds.27371

Cited by 8 publications

(3 citation statements)

References 7 publications

(7 reference statements)

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“…The SAS has a sensitivity of 66% and specificity of 100% [22, 23]. Individuals were excluded if they had significant symptoms of depression based on a score of 9 or above on the short form of the Geriatric Depression Scale [24, 25] or evidence of significant cognitive impairment based on a score of 4 or less on the Memory Impairment Screen [26]. These assessments were administered via telephone, prior to recruitment.…”

Section: Methodsmentioning

confidence: 99%

Barriers and facilitators to diagnosing and managing apathy in Parkinson’s disease: a qualitative study

et al. 2019

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Background Apathy is a prominent non-motor symptom in Parkinson’s disease (PD). People with apathy show a lack of emotion, passion, and motivation. Between 17 and 70% of persons with PD have apathy; the extreme heterogeneity in these estimates is due to limited heterogeneous knowledge concerning how to diagnose PD. The lack of a widely utilized diagnostic process limits understandings on how to treat and manage apathy in PD. A scoping review of apathy in PD identified only one qualitative study investigating this symptom. It was our objective to assess perceived barriers and facilitators to diagnosing, treating, and managing apathy in PD, as described by key stakeholders. Methods This research applied qualitative methodology, utilizing focus groups and interviews with health care practitioners (HCPs), persons with PD, and caregivers. Evidence gathered from a scoping review on apathy in PD informed discussions that took place with participants. Data collection and analysis was conducted using framework analysis, applying the Theoretical Domains Framework and Behaviour Change Wheel. Results Eleven HCPs and five persons with PD/caregivers participated. Themes included interdisciplinary teams and communication with family to facilitate diagnosis and treatment, and the use of education and increased awareness of apathy to facilitate management. Themes surrounding barriers included lack of initiative and motivation to maintain treatment plans, and a lack of evidence for apathy specific interventions. While a key barrier identified was the lack of information HCPs have access to, persons with PD and caregivers would prefer to receive a diagnosis of apathy even with limited management methods. Thus, education and awareness were noted as two of the most important facilitators, overall. Conclusion These findings suggest that diagnosing, treating, and managing apathy in PD requires interdisciplinary teams, that include family and caregivers. We identified that where HCPs perceive lack of knowledge as a barrier to diagnosis, persons with PD and caregivers find being given a diagnosis facilitates understanding. These findings highlight the importance of qualitative research involving persons with PD and apathy, caregivers, and HCPs who aid in management of this symptom. Barriers reported suggest future research must aim to identify apathy specific treatments, both pharmacologic and non-pharmacologic.

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Section: Methodsmentioning

confidence: 99%

Barriers and facilitators to diagnosing and managing apathy in Parkinson’s disease: a qualitative study

et al. 2019

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“…The GDS-15 is a brief self-report measure focusing on the psychological aspects (e.g., hopelessness) and social consequences of depression. The GDS-15 is a popular tool for screening d-PD with high specificity ( 12 ). According to GDS-15 scores, the PD patients were divided into two study groups: 28 d-PD patients with GDS-15 scores greater than or equal to 5 and 56 nd-PD patients with scores lower than 5 ( 13 ).…”

Section: Methodsmentioning

confidence: 99%

Structural Brain Network Alteration and its Correlation With Structural Impairments in Patients With Depression in de novo and Drug-Naïve Parkinson's Disease

Gou

Zhang

et al. 2018

Front. Neurol.

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Purpose: Depression is common in Parkinson's disease (PD) and is correlated with the severity of motor deficits and quality of life. The present study aimed to investigate alterations in the structural brain network related to depression in Parkinson's disease (d-PD) and their correlations with structural impairments of white matter (WM).Materials and Methods: Data were acquired from the Parkinson Progression Markers Initiative (PPMI) database. A total of 84 de novo and drug-naïve PD patients were screened and classified into two groups according to the 15-item Geriatric Depression Scale (GDS-15): d-PD (n = 28) and nondepression in PD (nd-PD, n = 56). Additionally, 37 healthy controls (HC) were screened. All subjects underwent DTI and 3D-T1WI on a 3.0 T MR scanner. Individual structural brain networks were constructed and analyses were performed using graph theory and network-based statistics (NBS) at both global and local levels. Differences in global topological properties were explored among the three groups. The association models between node and edge changes and the GDS-15 were constructed to detect regions that were specifically correlated with d-PD. Tract-based spatial statistics (TBSS) was used to detect structural impairments of WM between the d-PD and nd-PD groups. The correlations between altered global topological properties and structural impairments were analyzed in the d-PD group.Results: The global efficiency and characteristic path length of the structural brain network were impaired in the d-PD group compared with those in the nd-PD and HC groups. Thirteen nodes and 1 subnetwork with 10 nodes and 12 edges specifically correlated with d-PD were detected. The left hippocampus, left parahippocampal, left lingual, left middle occipital, left inferior occipital, left fusiform, left middle temporal, and left inferior temporal regions were all involved in the results of node and edge analysis. No WM microstructural impairments were identified in the d-PD group.Conclusion: Our study suggests that the integration of the structural brain network is impaired with disrupted connectivity of limbic system and visual system in the de novo and drug-naïve d-PD patients.The topological properties assessing integration of the structural brain network can serve as a potential objective neuroimaging marker for early diagnosis of d-PD.

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“…22 Finally, another analysis reported a 90.9% sensitivity and 89.3% specificity using a cut-point of 5 with the PHQ-9 in patients with PD. 23 However, no studies have compared the use of the PHQ-9 across neurologic subpopulations as a group.…”

Section: Discussionmentioning

confidence: 99%

Validity of the Patient Health Questionnaire-9 in neurologic populations

2020

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BackgroundBecause of symptom overlap, there is uncertainty about the validity of depression rating scales in neurologic populations. The objectives of this study were to evaluate the validity of the Patient Health Questionnaire-9 (PHQ-9) for detecting Diagnostic and Statistical Manual–defined major depressive episodes in people with neurologic conditions.MethodsParticipants were recruited from outpatient clinics for multiple sclerosis, epilepsy, migraine, Parkinson disease, and stroke for this cross-sectional study. Participants were administered a questionnaire (this included the PHQ-9), chart review, and a follow-up telephone interview. The Structured Clinical Interview for Depression was used as the reference standard for psychiatric diagnoses. The performance of PHQ-9 was analyzed using sensitivity, specificity, diagnostic odds ratios (DORs), and receiver operator curve analysis.ResultsAll neurologic subpopulations had a specificity greater than 78% and sensitivity greater than 79% at a cut-point of 10. Using a random-effects model, the I-squared value was 13.7%, and Tau2 was 0.05, showing homogeneity across the neurologic subpopulations. The pooled DOR was 25.3 (95% confidence interval [CI] 14.9–42.8). Meta-analytic analysis found that for sensitivity, the pooled estimate was 90% (95% CI 81–97), and for specificity, it was 85% (95% CI 79–90).ConclusionsDespite theoretical concerns about its validity, the PHQ-9 performed well at its standard cut-point of 10. Consistent with the literature, being able to use a validated, brief tool that is available publicly should improve case finding of depression in neurologic populations. When considering clinical practicality along with the findings of this analyzed, this study confirmed that the PHQ-9 is valid in a general outpatient neurologic population.

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Validating screening tools for depression in Parkinson's disease

Cited by 8 publications

References 7 publications

Barriers and facilitators to diagnosing and managing apathy in Parkinson’s disease: a qualitative study

Barriers and facilitators to diagnosing and managing apathy in Parkinson’s disease: a qualitative study

Structural Brain Network Alteration and its Correlation With Structural Impairments in Patients With Depression in de novo and Drug-Naïve Parkinson's Disease

Validity of the Patient Health Questionnaire-9 in neurologic populations

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