Depression in Parkinson\u27s disease: Health risks, etiology, and treatment options

Depression is found in about 30%-40% of all patients with Parkinson\u27s disease (PD), but only a small percentage (about 20%) receive treatment. As a consequence, many PD patients suffer with reduced health-related quality of life. To address quality of life in depressed PD patients, we reviewed the literature on the health correlates of depression in PD (eg, cognitive function), etiology of depression in PD, and treatment options (ie, antidepressants, electroconvulsive therapy, and psychotherapy). The current review is unique in its focus on psychosocial aspects, as well as neuropathological factors, of depression in PD. Overall, we conclude that neurochemical (eg, serotonin) and psychosocial factors (eg, coping style, self-esteem, and social support) contribute to the affective disturbances found in this neuropsychiatric population. Therefore, we recommend that a multidisciplinary (eg, pharmacotherapeutic, psychoeducational, and/or psychotherapeutic) approach to treatment be taken with depressed PD patients

Identification of emotion in a dichotic listening task: event-related brain potential and behavioral findings

The lateralization of emotion perception has been examined using stimuli in both auditory and visual modalities. Studies using dichotic stimuli have generally supported the hypothesis of right-hemisphere dominance for emotion perception, whereas studies of facial and verbal emotion perception have provided evidence for the right-hemisphere and valence hypotheses. A dichotic target detection task was developed to enable acquisition of event-related potentials (ERP) from subjects engaged in emotion detection. Nonsense syllables (e.g., ba, pa) stated in seven different emotional intonations were dichotically presented to 24 young adults, in a target detection task during four separate blocks (target emotions: happiness, interest, anger, or sadness). Accuracy and reaction time and ERP measures were also collected. ERPs were recorded from 14 scalp electrodes with a nose reference and quantified for N100, sustained negativity, late positivity, and slow wave. Significantly greater left-than right-ear accuracy was obtained for the identification of target prosodic emotion. Hemispheric asymmetries of N100 and sustained negativity This study is based on a doctoral dissertation conducted by the first author for Queens College and the Graduate School of the City University of New York. Partial support was provided by National Institutes of Mental Health Grants MH36295 (GB) and MH42172 ( JB). We are grateful to Drs. H. Ehrlichman, R. Johnson, and H. Sackeim for their insightful comments as members of the dissertation committee; to Dr. J. Towey for his contributions and support; to Dr. J. Welkowitz for consultation regarding aspects of methodology; to Dr. L. K. Obler for access to equipment during the stimulus development phase; and to D. Schechter for access to the normal subject pool at the New York State Psychiatric Institute. Address were found, with left-hemisphere amplitudes greater than right-hemisphere amplitudes. These ERP asymmetries were not significantly correlated with the left-ear dichotic advantage and may be related more to early phonetic processing than to emotion perception. Since the behavioral evidence supports the right-hemisphere hypothesis for emotion perception, behavioral and ERP asymmetries evident in this task reflect separable patterns of brain lateralization

Depression in Parkinson's disease: health risks, etiology, and treatment options

Depression is found in about 30%-40% of all patients with Parkinson's disease (PD), but only a small percentage (about 20%) receive treatment. As a consequence, many PD patients suffer with reduced health-related quality of life. To address quality of life in depressed PD patients, we reviewed the literature on the health correlates of depression in PD (eg, cognitive function), etiology of depression in PD, and treatment options (ie, antidepressants, electroconvulsive therapy, and psychotherapy). The current review is unique in its focus on psychosocial aspects, as well as neuropathological factors, of depression in PD. Overall, we conclude that neurochemical (eg, serotonin) and psychosocial factors (eg, coping style, self-esteem, and social support) contribute to the affective disturbances found in this neuropsychiatric population. Therefore, we recommend that a multidisciplinary (eg, pharmacotherapeutic, psychoeducational, and/or psychotherapeutic) approach to treatment be taken with depressed PD patients. © 2008 Dove Medical Press Limited. All rights reserved

Depression in Parkinson’s disease: Health risks, etiology, and treatment options

Pasquale G Frisina1,2, Joan C Borod3,4, Nancy S Foldi3,5, Harriet R Tenenbaum61Leir Parkinson’s Disease Program, The Jewish Home and Hospital Lifecare System, New York, NY, USA; 2Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY, USA; 3Department of Psychology, Queens College and The Graduate Center of the City University of New York (CUNY), Flushing, NY, USA; 4Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA; 5Department of Medicine, Winthrop-University Hospital, State University of New York, Stony Brook School of Medicine; 6Department of Psychology, Kingston University, Kingston upon Thames, UKAbstract: Depression is found in about 30%–40% of all patients with Parkinson’s disease (PD), but only a small percentage (about 20%) receive treatment. As a consequence, many PD patients suffer with reduced health-related quality of life. To address quality of life in depressed PD patients, we reviewed the literature on the health correlates of depression in PD (eg, cognitive function), etiology of depression in PD, and treatment options (ie, antidepressants, electroconvulsive therapy, and psychotherapy). The current review is unique in its focus on psychosocial aspects, as well as neuropathological factors, of depression in PD. Overall, we conclude that neurochemical (eg, serotonin) and psychosocial factors (eg, coping style, self-esteem, and social support) contribute to the affective disturbances found in this neuropsychiatric population. Therefore, we recommend that a multidisciplinary (eg, pharmacotherapeutic, psychoeducational, and/or psychotherapeutic) approach to treatment be taken with depressed PD patients.Keywords: depression, Parkinson’s disease, health outcomes, treatment option

The effects of antidepressants in Parkinson's disease: a meta-analysis

This study explored the therapeutic effect of antidepressants in Parkinson's disease (PD) using a meta-analysis. Altogether, 24 placebo-controlled trials qualified for inclusion and revealed that tricyclic antidepressants (TCAs) had a greater antidepressant effect relative to selective serotonin reuptake inhibitors (SSRIs), Qb(1) = 8.87, p <.01, and the mono-amine-oxidase inhibitor, selegiline, Qb(1) = 7.90, p <.01. Whereas TCAs produced a significant side effect profile (odds ratio = 3.07), adverse events were negligible with SSRIs (odds ratio = 1.83) and selegeline (odds ratio = 1.63). Antidepressants can be beneficial for patients with PD. However, the choice of antidepressants needs to take depressive symptomatologies into account while monitoring side effects. Copyright © 2008 Informa Healthcare USA, Inc

Cognitive and Affective Functioning in Parkinson's Disease Patients with Lateralized Motor Signs

Eleven patients with Parkinson’s disease (PD) and predominantly right-sided motor signs, 12 patients with PD and predominantly left-sided signs, and 11 demographically matched healthy controls were compared on tests assessing a range of cognitive and affective functions. Assuming a novel approach, our test battery was composed of measures drawn from ones previously used in the hemiparkinson’s disease and lateralized PD literature. The two patient groups were similar in illness duration, severity of motor signs, and degree of lateralized motor deficits. Statistical analyses did not reveal significant differences between patient groups, consistent with other studies that have failed to find differences in neuropsychological functioning between PD patients with right- and left-sided motor signs