Abstract
Depression is the most common psychological disturbance that affects people with Parkinson’s disease (PD). Despite an increasing amount of research devoted to this topic, uncertainty still exists concerning many aspects of depression in PD. Significant questions remain regarding some very basic issues, including how best to diagnose depression in PD, how frequently depression complicates PD, the risk factors for developing depression, and how best to treat depression. This chapter provides a current perspective on what is known about depression in PD, reviewing its epidemiology, etiology, and treatment. Rather than providing a comprehensive overview, the focus here is on updating the major themes of research in this field.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Kuhn W, Heye N, Muller TH, et al. The motor performance test series in Parkinson’s disease is influenced by depression. J Neural Transm. 1996;103:349–54.
Schrag A, Jahanshahi M, Quinn N. What contributes to quality of life in patients with Parkinson’s disease? J Neurol Neurosurg Psychiatry. 2000;69:308–12.
Weintraub D, Moberg PJ, Duda JE, Katz IR, Stern MB. Effect of psychiatric and other nonmotor symptoms on disability in Parkinson’s disease. J Am Geriatr Soc. 2004;52:784–8.
Chen P, Kales HC, Weintraub D, et al. Depression in veterans with Parkinson’s disease: frequency, co-morbidity, and healthcare utilization. Int J Geriatr Psychiatry. 2007;22:543–8.
Reijnders JS, Uwe E, Weber WEJ, Aarsland D, Leentjens AFG. A systematic review of prevalence studies of depression in Parkinson’s disease. Mov Disord. 2008;23:183–9.
Leentjens AFG. Depression in Parkinson’s disease: conceptual issues and clinical challenges. J Geriatr Psychiatry Neurol. 2004;17:120–6.
Cummings JL. Depression and Parkinson’s disease: a review. Am J Psychiatry. 1992;149:443–54.
Chen P, Kales HC, Weintraub D, Blow FC, Jiang L, Mellow AM. Antidepressant treatment of veterans with Parkinson’s disease and depression. J Geriatr Psychiatry Neurol. 2007;20(3):161–5.
Tandberg E, Larsen JP, Aarsland D, Cummings JL. The occurrence of depression in Parkinson’s disease. A community-based study. Arch Neurol. 1996;53:175–9.
Weintraub D. Diagnosing and treating depression in patients with Parkinson’s disease. Psychiatric Ann. 2004;34:299–304.
Veazy C, Aki SOE, Cook KF, Lai EC, Kunik ME. Prevalence and treatment of depression in Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 2005;17:310–23.
Goldberg DP, William P. A user’s guide to the General Health Questionnaire. Windsor: NFER-Nelson; 1988.
Hantz P, Caradoc-Davies G, Caradoc-Davies T, et al. Depression in Parkinson’s disease. Am J Psychiatry. 1994;151:1010–4.
Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.
Starkstein SE, Preziosi TJ, Bolduc PL, Robinson RG. Depression in Parkinson’s disease. J Nerv Ment Dis. 1990;178:27–31.
Celesia GG, Wanamaker WM. Psychiatric disturbances in Parkinson’s disease. Dis Nerv Syst. 1976;37:123–5.
Brown R, Jahanshahi M. Depression in Parkinson’s disease: a psychosocial viewpoint. Adv Neurol. 1995;65:61–84.
Starkstein SE, Berthier ML, Bolduc PL, et al. Depression in patients with early versus late onset Parkinson’s disease. Neurology. 1989;39:1441–5.
Gotham AM, Brown RG, Marsden CD. Depression in Parkinson’s disease: a quantitative and qualitative analysis. J Neurol Neurosurg Psychiatry. 1986;49:381–9.
Brown RC, MacCarthy B. Psychiatric morbidity in patients with Parkinson’s disease. Psychol Med. 1990;20:77–87.
Huber SJ, Paulson GW, Shuttleworth EC. Depression in Parkinson’s disease. Neuropsychiatry Neuropsychol Behav Neurol. 1988;1:47–51.
Jankovic J, McDermott M, Carter J, et al. Parkinson Study Group. Variable expression of Parkinson’s disease: a baseline analysis of the DATATOP cohort. Neurology. 1990;40:1529–34.
Brown GL, Wilson WP. Parkinsonism and depression. South Med J. 1972;65:540–5.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
Leentjens AFG, Marinus J, Van Hilten JJ, et al. The contribution of somatic symptoms to the diagnosis of depressive disorder in Parkinson’s disease: a discriminant analytic approach. J Neuropsychiatry Clin Neurosci. 2003;15:74–7.
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.
Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382–9.
Marsh L, McDonald WM, Cummings J, Ravina B, the NINDS/NIMH Work Group on Depression and Parkinson’s Disease. Provisional diagnostic criteria for depression in Parkinson’s disease: report of an NINDS/NIMH Work Group. Mov Disord. 2006;21:148–58.
Burke WJ, Rubin EH, Morris J, Berg L. Symptoms of depression in dementia of the Alzheimer type. Alzheimer Dis Assoc Disord. 1988;2:356–62.
Gonera EG, van’t Hof M, Berger HJ, et al. Symptoms and duration of the prodromal phase in Parkinson’s disease. Mov Disord. 1997;12:871–6.
Schuurman AG, van den Akker M, Ensinck K, et al. Increased risk of Parkinson’s disease after depression: a retrospective cohort study. Neurology. 2002;58:1501–4.
Leentjens AFG, Van den Akker M, Metsemakers JFM, Lousberg R, Verhey FRJ. Higher incidence of depression preceding the onset of Parkinson’s disease: a register study. Mov Disord. 2003;18:414–8.
Ishihara L, Brayne C. A systematic review of depression and mental illness preceding Parkinson’s disease. Acta Neurol Scand. 2006;113:211–20.
Krishnan KR, Delong M, Kraemer H, et al. Comorbidity of depression with other medical diseases in the elderly. Biol Psychiatry. 2002;52:559–88.
Nilsson FM, Kessing LV, Sorensen TM, et al. Major depressive disorder in Parkinson’s disease: a register-based study. Acta Psychiatr Scand. 2002;106:202–11.
Leentjens AFG, Lousberg R, Verhey FJR. Markers for depression in Parkinson’s disease. Acta Psychiatr Scand. 2002;106:196–201.
MacCarthy B, Brown RG. Psychosocial factors in Parkinson’s disease. Br J Clin Psychol. 1989;28:41–52.
Oertel WH, Hoglinger GU, Caraceni T, et al. Depression in Parkinson’s disease. Adv Neurol. 2001;86:373–83.
Mayeux R, Stern Y, Cote L, Williams BW. Altered serotonin metabolism in depressed patients with Parkinson’s disease. Neurology. 1984;34(5):642–6.
Mayeux R. The “serotonergic hypothesis” for depression in Parkinson’s disease. Adv Neurol. 1990;53:163–6.
Fibiger HC. The neurobiological substrates of depression in Parkinson’s disease: a hypothesis. Can J Neurol Sci. 1984;11:105–7.
Price KS, Farley IJ, Hornykiewicz O. Neurochemistry of Parkinson’s disease: relation between striatal and limbic dopamine. Adv Biochem Psychopharmacol. 1978;19:293–300.
Javoy-Agid F, Agid Y. Is the mesocortical dopaminergic system involved in Parkinson’s disease? Neurology. 1980;30:1326–30.
Baxter Jr LR, Schwartz JM, Phelps ME, et al. Reduction of prefrontal cortex glucose metabolism common to three types of depression. Arch Gen Psychiatry. 1989;46:243–50.
Zarow C, Lyness SA, Mortimer JA, Chui HC. Neuronal loss is greater in the locus coeruleus than nucleus basalis and substantia nigra in Alzheimer and Parkinson Diseases. Arch Neurol. 2003;60:337–41.
Remy P, Doder M, Lees A, Turjanski N, Brooks D. Depression in Parkinson’s disease: loss of dopamine and noradrenaline innervation in the limbic system. Brain. 2005;128:1314–22.
Bejjani BP, Damier P, Arnulf I, et al. Transient acute depression induced by high-frequency deep-brain stimulation. N Engl J Med. 1999;340:1476–80.
Alexopoulos G, Kiosses D, Klimstra S, Kalayam B, Bruce M. Clinical presentation of the “depression-executive dysfunction syndrome” of late life. Am J Geriatr Psychiatry. 2002;10:98–106.
Des Rosiers G. Primary or depressive dementia: mental status screening. Int J Neurosci. 1992;64:33–67.
LaRue A. Aging and neuropsychological assessment. New York: Plenum; 1992. p. 259–89.
Rosenstein LD. Differential diagnosis of the major progressive dementias and depression in middle and late adulthood: a summary of the literature of the early 1990s. Neuropsychol Rev. 1998;8:109–67.
Mayeux R. Depression in the patient with Parkinson’s disease. J Clin Psychiatry. 1990;51(suppl):20–3.
Factor SA, Molho ES, Podskalny GD, Brown D. Parkinson’s disease: drug-induced psychiatric states. Adv Neurol. 1995;65:115–38.
Barone P, Scarzella L, Marconi R, et al. For the Depression/Parkinson Italian Study Group. Pramipexole versus sertraline in the treatment of depression in Parkinson’s disease: a national multicenter parallel-group randomized study. J Neurol. 2006;253:601–7.
Rektorova I, Rektor I, Bares M, et al. Pramipexole and pergolide in the treatment of depression in Parkinson’s disease: a national multicentre prospective randomized study. Eur J Neurol. 2003;10:399–406.
Leentjens AFG, Koester J, Fruh B, Shephard DTS, Barone P, Houben JJG. The effect of pramipexole on mood and motivational symptoms in Parkinson’s disease: a meta-analysis of placebo-controlled studies. Clin Ther. 2009;31:89–98.
Jouvent R, Abensour P, Bonnett AM, et al. Antiparkinsonian and antidepressant effects of high doses of bromocriptine: an independent comparison. J Affect Disord. 1983;5:141–5.
Allain H, Pollak P, Neukirch HC, et al. Symptomatic effect of selegiline in de novo parkinsonian patients: the French selegiline multicenter trial. Mov Disord. 1993;8 Suppl 1:36–40.
Steur ENHJ, Ballering LAP. Combined and selective monamine oxidase inhibition in the treatment of depression in Parkinson’s disease. In: Stern GM, editor. Parkinson’s disease: advances in neurology, vol. 80. Philadelphia, PA: Lippincott Williams & Wilkins; 1999. p. 505–8.
Thobois S, Mertens P, Guenot M, et al. Subthalamic nucleus stimulation in Parkinson’s disease: clinical evaluation of 18 patients. J Neurol. 2002;249:529–34.
Krack P, Batir A, Blercom N, et al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med. 2003;349:1925–34.
Herzog J, Volkmann J, Krack P, et al. Two-year follow-up of subthalamic deep brain stimulation in Parkinson’s disease. Mov Disord. 2003;18:1332–7.
Martinez-Martin P, Valldeoriola F, Tolosa E, et al. Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson’s disease. Mov Disord. 2002;17:372–7.
Smeding HMM, Speelman JD, Koning-Haanstra M, Schuurman PR, Nijssen P, Van Laar T, Schmand B. Neuropsychological effects of bilateral STN stimulation in Parkinson’s disease: a controlled study. Neurology. 2006;66:1830–6.
Deuschl G, Schade-Brittinger C, Krack P, et al. For the German Parkinson Study Group, Neurostimulation Section. A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med. 2006;355:896–908.
Funkiewiez A, Ardouin C, Krack P, et al. Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson’s disease. Mov Disord. 2003;18:524–30.
Voon V, Krack P, Lang AE, et al. A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson’s disease. Brain. 2008;131:2720–8.
Soulas T, Gurruchaga JM, Palfi S, Cesaro P, Nguyen JP, Fenelon G. Attempted and completed suicides after subthalamic nucleus stimulation for Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2008;79:952–4.
Houeto JL, Mesnage V, Mallet L, et al. Behavioral disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry. 2002;72:701–7.
Burkhard PR, Vingerhoets FJG, Berney A, Bogousslavsky J, Villemure JG, Ghika J. Suicide after successful deep brain stimulation for movement disorders. Neurology. 2004;63:2170–2.
Berney A, Vingerhoets F, Perrin A, et al. Effect on mood of subthalamic DBS for Parkinson’s disease: a consecutive series of 24 patients. Neurology. 2002;59:1427–9.
Doshi PK, Chhaya N, Bhatt MH. Depression leading to attempted suicide after bilateral subthalamic nucleus stimulation for Parkinson’s disease. Mov Disord. 2002;17:1084–100.
Romito LM, Raja M, Daniele A, et al. Transient mania with hypersexuality after surgery for high-frequency stimulation of the subthalamic nucleus in Parkinson’s disease. Mov Disord. 2002;17:1371–4.
Kulisevsky J, Berthier ML, Gironell A, et al. Mania following deep brain stimulation for Parkinson’s disease. Neurology. 2002;59:1421–4.
Witt K, Daniels C, Reiff J, et al. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s disease: a randomized multicentre study. Lancet Neurol. 2008;7:605–14.
Myslobodsky M, Lalonde FM, Hicks L. Are patients with Parkinson’s disease suicidal? J Geriatr Psychiatry Neurol. 2001;14:120–4.
Voon V, Krack P, Lang A, et al. Factors associated with suicide risk following STN DBS for Parkinson’s disease. Mov Disord. 2006;21 Suppl 15:S691.
Schlaepfer TE, Fins JJ. Deep brain stimulation and the neuroethics of responsible publishing, when one is not enough. JAMA. 2010;303:775–6.
Agid Y, Schupback M, Gargiulo M, et al. Neurosurgery in Parkinson’s disease: the doctor is happy, the patient less so? J Neural Transm Suppl. 2006;70:409–14.
Voon V, Saint-Cyr J, Lozano AM, Moro E, Poon YY, Lang AE. Psychiatric symptoms in patients with Parkinson disease presenting for deep brain stimulation surgery. J Neurosurg. 2005;103:246–51.
Mendis T, Suchowersky O, Lang A, Gauthier S. Management of Parkinson’s disease: a review of current and new therapies. Can J Neurol Sci. 1999;26:89–103.
Lieberman A. Managing the neuropsychiatric symptoms of Parkinson’s disease. Neurology. 1998;50:S33–8.
Poewe W, Seppi K. Treatment options for depression and psychosis in Parkinson’s disease. J Neurol. 2001;248 Suppl 3:III12–21.
Miyasaki JM, Shannon K, Voon V, et al. Practice parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson’s disease (an evidence-based review): report of the quality standards subcommittee of the American academy of neurology. Neurology. 2006;66:996–1002.
Weintraub D, Morales KH, Moberg PJ, et al. Antidepressant studies in Parkinson’s disease: a review and meta-analysis. Mov Disord. 2005;20:1161–9.
Menza M, Dobkin RD, Marin H, et al. A controlled trial of antidepressants in patients with Parkinson disease and depression. Neurology. 2009;72:886–92.
Leentjens AFG, Vreeling FW, Luijckx GJ, Verhey FRJ. SSRIs in the treatment of depression in Parkinson’s disease. Int J Geriatr Psychiatry. 2003;18:552–4.
Menza M, Marin H, Kaufman K, Mark M, Lauritano M. Citalopram treatment of depression in Parkinson’s disease: the impact on anxiety, disability, and cognition. J Neuropsychiatry Clin Neurosci. 2004;16:315–9.
Antonini A, Tesei S, Zecchinelli A, et al. Randomized study of sertraline and low-dose amitriptyline in patients with Parkinson’s disease and depression: effect on quality of life. Mov Disord. 2006;21:1119–22.
Ceravolo R, Nuti A, Piccinni A, et al. Paroxetine in Parkinson’s disease: effects on motor and depressive symptoms. Neurology. 2000;55:1216–8.
Tesei A, Antonini A, Canesi M, et al. Tolerability of paroxetine in Parkinson’s disease: a prospective study. Mov Disord. 2000;15:986–9.
Dell’Agnello G, Ceravolo R, Nuti A, et al. SSRIs do not worsen Parkinson’s disease: evidence from an open-label, prospective study. Clin Neuropharmacol. 2001;24:221–7.
Hauser RA, Zesiewicz TA. Sertraline for the treatment of depression in Parkinson’s disease. Mov Disord. 1997;12:756–9.
Weintraub D, Taraborelli D, Morales K, Duda JE, Katz IR, Stern MB. Escitalopram for major depression in Parkinson’s disease: an open-label, flexible-dosage study. J Neuropsychiatry Clin Neurosci. 2006;18:377–83.
Wermuth L, Sorensen PS, Timm S, et al. Depression in idiopathic Parkinson’s disease treated with citalopram. Nord J Psychiatry. 1998;52:163–9.
Andersen J, Aabro E, Gullmann N, et al. Antidepressive treatment in Parkinson’s disease: a controlled trial of the effect of nortriptyline in patients with Parkinson’s disease treated with l-dopa. Acta Neurol Scand. 1980;62:210–9.
Laitinen L. Desipramine in the treatment of Parkinson’s disease: a placebo-controlled study. Acta Neurol Scand. 1969;45:109–13.
Devos D, Dujardin K, Poirot I, et al. Comparison of desipramine and citalopram treatments for depression in Parkinson’s disease: a double-blind, randomized, placebo-controlled study. Mov Disord. 2008;23:850–7.
Ritter JL, Alexander B. Retrospective study of selegiline-antidepressant drug interactions and a review of the literature. Ann Clin Psychiatry. 1997;9:7–13.
Richard IH, Kurlan R, Tanner C, et al. Serotonin syndrome and the combined use of deprenyl and an antidepressant in Parkinson’s disease. Neurology. 1997;48:1070–7.
Djaldetti R, Yust-Katz S, Kolianov V, Melamed E, Dabby R. The effect of duloxetine on primary pain symptoms in Parkinson disease. Clin Neuropharmacol. 2007;30:201–5.
Onofrj M, Luciano AL, Thomas A, et al. Mirtazapine induces REM sleep behavior disorder (RBD) in Parkinsonism. Neurology. 2003;60:113–5.
The American Psychiatric Association practice guidelines: major depressive disorder. 2nd ed. http://www.psychiatryonine.com/pracGuide/pracGuideTopic_7.aspx. Accessed 1 Mar 2010.
Burke WJ, Peterson J, Rubin EH. Electroconvulsive therapy in the treatment of combined depression and Parkinson’s disease. Psychosomatics. 1988;29:341–6.
Popeo D, Kellner CH. ECT for Parkinson’s disease. Med Hypotheses. 2009;73:468–9.
Wengel SP, Burke WJ, Pfeiffer RF, et al. Maintenance electroconvulsive therapy for intractable Parkinson’s disease. Am J Geriatr Psychiatry. 1998;6:263–9.
Andersen K, Balldin J, Gottfries CG, et al. A double-blind evaluation of electroconvulsive therapy in Parkinson’s disease with “on-off” phenomena. Acta Neurol Scand. 1987;76:191–9.
Shulman R. Maintenance ECT in the treatment of PD: therapy improves psychotic symptoms, physical function. Geriatrics. 2003;58:43–5.
Aarsland D, Larsen JP, Waage O, Langeveld JH. Maintenance electroconvulsive therapy for Parkinson’s disease. Convuls Ther. 1997;13:274–7.
Fall PA, Granerus AK. Maintenance ECT in Parkinson’s disease. J Neural Transm. 1999;106:737–41.
Bailine S, Kremen N, Kohen I, et al. Bitemporal electroconvulsive therapy for depression in a Parkinson disease patient with a deep-brain stimulator. J ECT. 2008;24:171–2.
Chou KL, Hurtig HI, Jaggi JL, Baltuch GH, Pelchat RJ, Weintraub D. Electroconvulsive therapy for depression in a Parkinson’s disease patient with bilateral subthalamic nucleus deep brain stimulators. Parkinsonism Relat Disord. 2005;11:403–6.
Moscarillo FM, Annunziata CM. ECT in a patient with a deep brain stimulating electrode in place. J ECT. 2000;16:287–90.
Rasmussen K, Abrams R. Treatment of Parkinson’s disease with electroconvulsive therapy. Psychiatr Clin North Am. 1991;14:925–33.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Benton, J.L., Wengel, S.P., Burke, W.J. (2013). Depression in Parkinson’s Disease: An Update. In: Pfeiffer, R.F., Bodis-Wollner, I. (eds) Parkinson’s Disease and Nonmotor Dysfunction. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-429-6_1
Download citation
DOI: https://doi.org/10.1007/978-1-60761-429-6_1
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-60761-428-9
Online ISBN: 978-1-60761-429-6
eBook Packages: MedicineMedicine (R0)