Depression Can Be Worst Part of Parkinson’s

12/3/2012

Read this Psych Central article about early findings from the National Parkinson Foundation's Parkinson's Outcomes Project, the largest clinical study of Parkinson's disease ever conducted, showing that depression is the most important factor influencing the health status of Parkinson's patients.


For those suffering from Parkinson’s disease, depression can be more of a burden than  the physical symptoms of the disease, according to early findings of the largest study conducted on the illness.

“It’s not because they’re sad they have the disease, which they may very well be, but this depression is related to underlying changes in the brain, and for many, it will occur before diagnosis of Parkinson’s,” said Dr. Laura Marsh, director of mental health services at the Veterans Affairs Medical Center in Houston.

“The more aggressively it is treated, the better the outcome,” she said. “There’s a real problem with under- recognition and under-treatment.”

The disease affects about 1 million people in the USA and 5 million worldwide, and is characterized by tremors, stiffness, slowness of movement and speech difficulties. There is no cure.

“Nearly everyone thinks of the disease as a mobility disorder, but the number one problem turns out to be depression,” said Joyce Oberdorf, president of the National Parkinson Foundation, an advocacy group.

For the study, which began three years ago, researchers set out to determine which treatments allow some patients to thrive while others decline.

“Some patients stay active and can live at home rather than go to a nursing home,” said physician Dr. Michael Okun, co-director of the Center for Movement Disorders and Neurorestoration at the University of Florida.

“There’s a wide disparity of treatments. We wanted to know what treatments were improving quality of life and to set guidelines for good outcomes.”

The project involves 20 research centers and 5,557 patients. Each year, patients fill out a health survey, and their responses are entered into a database.

The early findings on depression show the “magnitude of the problem,” said physician Dr. Laura Marsh.

Results show that 61% of the patients have depression, with 21% of these reporting minor symptoms, 22% mild depression, and 18% severe depressive disorders.

Patients who receive both medication and supportive therapy for depression do the best, says Marsh. Until depression is addressed, she adds, patients might not want to exercise, an important therapy for the disease.

“The more exercise you get, the more it helps with stiffness. It can also help prevent falls as the disease progresses,” said Okun. “Exercise might actually modify the disease.”

Exercise can also elevate mood, he adds.

—Traci Pedersen

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