Abstract
Major depressive disorder (MDD) is a major health problem in Parkinson’s disease (PD) patients. We described the clinical and sociodemographic factors of MDD among patients with PD at a national neurological referral center in Mexico. One hundred patients with PD + MDD were included in the study. All the patients were evaluated during the “ON” treatment phase of PD. Clinical scales for cognition (MMSE and MoCA) and MDD (MADRS) were applied. The mean age was 58.49 ± 11.02 years, and 57% of the sample was male. The most frequent symptom of PD was tremor (67%), and onset was more frequent on the right side (57%). Additionally, 49% of the patients with PD had moderate to severe (M/S) MDD. Selective serotonin reuptake inhibitors were the most frequent antidepressant treatment (69%). The scores of the scales were MADRS 21.33 ± 5.49, MoCA 21.06 ± 4.65, and MMSE 26.67 ± 1.20. The females had lower MMSE scores compared to the males (p = 0.043). The patients with M/S MDD had more rigidity at the beginning of PD (p = 0.005), fewer march alterations (p = 0.023), and a greater prevalence of left-side initial disease (p = 0.037). Rigidity was associated with M/S MDD (OR 3.75 p = 0.013). MDD was slightly more frequent in the males than in the females. The MDD symptoms and cognitive impairment were worse in the female population.
Highlights
Parkinson’s disease (PD) is a complex illness and the second most common neurodegenerative disorder, affecting 1% of the population over 60 and up to 4% over the age of 80 [1]
When we made the comparison between onset with tremor (OWT) and onset with other symptoms (OWOS), we found that the group that begins only with tremor had a greater number of patients affected with arterial hypertension (AH) (14.49%, n = 10)
We aimed to describe the sociodemographic and clinical variables of PD patients diagnosed with major depressive disorder (MDD) at the outpatient clinic of a national neurological referral center
Summary
Parkinson’s disease (PD) is a complex illness and the second most common neurodegenerative disorder, affecting 1% of the population over 60 and up to 4% over the age of 80 [1]. In addition to classical motor symptoms (bradykinesia, rest tremor, or rigidity), the presence of non-motor features, such as hyposmia, sleep behavior disorder, cognitive impairment, pain, autonomic dysfunction, and psychiatric disturbances, are relevant. Psychiatric symptoms, such as major depressive disorder (MDD), anxiety, hallucination, delusion, apathy and anhedonia, impulsive and compulsive behavior, and cognitive dysfunction, appear to be present in most PD patients [4]. MDD is not exclusive to the population over 60 years with PD and may occur in a population under 50 years of age, as in the case of early-onset and juvenile- and young-onset PD In this population of onset before the age of 50, a prevalence of MDD up to 45.6% has been found [5]. It may be challenging to identify clinical MDD in PD patients [7]
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