Sunday, August 16, 2009

Having depression before your diagnosis of PD affects QOL

Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Wed Aug 05, 2009 12:12 pm Post subject: Having depression before your diagnosis of PD affects QOL

Dear forum members, The relationship between depression and quality of life in PD has been something we feel is deserving of more research. A small study was recently published commenting on this relationship. Interestingly, if you had depression prior to your PD diagnosis it may affect your quality of life (QOL) post diagnosis (or be related to it). The abstract is below: Parkinsonism Relat Disord. 2009 Jul 27. [Epub ahead of print]Links Impact of pre-morbid depression on health-related quality of life in non-demented Parkinson's disease patients. Klepac N, Hajnšek S, Trkulja V. Department of Neurology, University Hospital Centre Zagreb, Zagreb University School of Medicine, Kispatićeva 12, Zagreb, Croatia. The need to understand and improve health-related quality of life (Hr-QoL) in Parkinson's disease (PD) has been emphasized. In order to investigate contributions of depression that existed before the onset of typical motor symptoms ("pre-PD depression"), idiopathic non-demented non-psychotic patients with (n = 32) and without (n = 120) a history of pre-PD depression, free of relevant comorbidity, calliper-matched for age, education and disease duration were evaluated for motor and non-motor disease aspects and Hr-QoL (Parkinson's Disease Questionnaire 39, PDQ-39). History of pre-PD depression was independently associated with higher actual levels of depression and anxiety, poorer sleep quality and mental set shifting, which all contributed to poorer Hr-QoL. Mediation analysis demonstrated significant indirect effects (mediated through the effects on mood/emotion/sleep and/or cognition) of pre-PD depression on PDQ summary index and subscales, but also direct (non-mediated) effects on emotional well-being and body discomfort subscales independent of the sociodemographic, motor/non-motor disease or treatment-related characteristics. Data indicate that for a given level of motor/non-motor PD symptoms severity, history of pre-PD depression contributes to poorer Hr-QoL._________________Michael S. Okun, M.D.

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