Clinical feature,influence factor and treatment of Parkinson disease with depression

Objective To investigate the clinical characteristics and influencing factors of Parkinson disease(PD) with depression(PDD),and to provide a better treatment for the disease.Methods Depressive states of 81 PD patients were evaluated with Zung Self-rating depressive scale(SDS) and Hamilton depression scale(HAMD).Meanwhile the seven factors scores of HAMD were recorded.Unified PD rating scale(UPDRS) and Hoehn-Yahr stages were used to evaluate the symptom severity of PD and the clinical type were decided:tremor type and rigidity type.According to SDS and HAMD,all patients were divided into two groups:PDD group and nondepressed PD(PDND) group.The differences of gender,age,course,UPDRS scores,Hoehn-Yahr stages and clinical type were compared between two groups.UPDRS and HAMD scores of PDD were recorded after 30 days in the patients who were administrated anti-Pakinson drugs accompanied with antidepressants or anti-Pakinson drugs alone.Results Fifty-two(64.2%) patients of 81 patients were PDD patients.Among these 52 patients,31(59.6%) patients were light depression,21(40.4%) patients were moderate and severe depression.The rate of depression in tremor type was 44.4% and that of rigidity type was 69.8%.UPDRS scores of PDD group were higher than those of PDND group.Anxiety/somatization,cognitive disturbance,blockage,sleep disorder and feeling of desire were the main characters of PDD.The patients who had higher UPDRS scores,higher Hoehn-Yahr stages were female,rigidity type had higher risk of attack of depression,and the difference was significant.UPDRS score and HAMD score of PDD patients who were given anti-Pakinson drugs accompanied with antidepressants decreased greatly than the patients who were given anti-Pakinson drugs only.Conclusion Depression is a very common psychological obstacle in PD patients,and majority is light depression.Female,rigidity type,severe PD patients have a higher risk of attack of depression.Anti-Parkinson drugs accompanied with antidepressants used to treat PDD decrease UPDRS and HAMD scores significantly and improve the clinical symptom compared to anti-Parkinson drugs only.