|Title of PI||Defining the phenotype of depression in Parkinson’s disease: a prospective longitudinal study of clinical features, risk factors and impact on outcome|
|Professor||Richard||Brown||Institute of Psychiatry, KCL||UK|
|Dr||John||Hindle||North West Wales NHS Trust||Wales|
|Dr||Sabine||Landau||Institute of Psychiatry, KCL||UK|
|Dr||Jeremy||Playfer||Royal Liverpool Hospital||UK|
|Dr||Mike||Samuel||King’s College Hospital NHS Foundation Trust||UK|
|Institution||King’s College London|
|Street Address||Institute of Psychiatry, De Crespigny Park|
- United Kingdom
- Parkinson’s disease
Depression and anxiety are common in people with Parkinson’s disease with as many as 30?40% of patients reporting significant symptoms. Evidence from cross-sectional studies suggests that such symptoms are strongly associated with increased disability and reduced quality of life, and may be associated with increased risk of dementia. The directions of these relationships, however, are uncertain. The relationship between mood problems and the underlying disease process also remains unclear and clinical management is widely regarded as inadequate, with a paucity of controlled clinical trials to guide effective treatment.
A major limitation of current knowledge is the absence of evidence from large prospectively studied groups of patients. Such evidence is necessary to more clearly identify the risk factors for mood disturbance (offering clues as to cause), their clinical characteristics and impact on patient outcome.
A further limitation of existing research is a widespread dissatisfaction with standard psychiatric diagnostic systems (such as DSM?IV) for identifying depression and anxiety disorders in older adults, and particularly those with chronic health problems. The sole reliance on such systems is seen as a barrier to future research, and clinical trials. Once again, progress in this area is dependent on having detailed prospectively gathered data on a large and representative group of patients.
Finally, there is growing evidence, from research in Parkinson’s disease and other groups, that mood disturbance as defined by systems such as DSM?IV can present in different ways in different patients. These is already evidence from other sources (e.g. late life depression) that different symptom patterns and clinical profile may reflect fundamentally different disorders, with distinctive underlying causes requiring targeted treatment approaches, and with different implications for medium and long-term outcome.
The present study will use a range of approaches to identify potentially more valid and useful ways to define mood disturbance in Parkinson’s disease to aid future research and clinical care. To do this, larger groups of patients are required than used in previous research with a more detailed assessment of symptoms and associated clinical features. Through the longitudinal study over several years of a large cohort of patients, the study will provide important information to improve our knowledge and understanding of mood disorder in Parkinson’s disease, aid in the improved identification of such problems, inform clinical management and facilitate future research including clinical trials of treatments.
- Basic research