Pain and Its Relationship to Depression in Parkinson Disease

Abstract

Depression and pain are common in Parkinson disease (PD). An association between pain and depression has been demonstrated in non-PD groups, but little is known about this relationship in PD. The authors examined the relationship between pain and depression in a community-based sample of patients with PD. Two hundred twenty-seven patients with PD were drawn from a community-based prevalence study. A random sample of 100 healthy elderly comparable regarding age and sex were included for comparison. Pain was assessed by employing the pain section of the Nottingham Health Profile and depression by the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI). General linear models and regression analyses were used to study the relationship between pain and depression. Sixty-seven percent of PD patients suffered from pain, compared with 39% of the control group. PD subjects with pain had higher scores on MADRS and BDI, and were more likely to have major depression, than PD patients without pain. In multivariate analyses, the presence of pain was significantly associated with depression scores, even after adjusting for demographic and clinical variables. A significant relationship between pain and depression was found. Pain issues should be integrated in the evaluation and management of depression in PD, and vice versa.