Objective: The objective of this study was to correlate PD severity with depression.

Background:
​​​​Depression is the most common psychiatric disorder in patients with PD. In clinical practice there are several standardised scales used for the assessment of PD severity and progression but evaluation of depression is unfairly neglected in clinical routine, in spite of the fact that it is not time consuming and it is easy to perform by neurologist.

Method: There were 60 PD patients (42 men, 18 women; mean age 64.6 years) divided according to age into 3 groups: 
< 55 years; 55-64 years; >65 years. According to PD progression, assessed by the Hoehn and Yahr Scale (H&Y), there were 2 groups of PD patients, with the boundary set at the H&Y stage 3 (bilateral disease: mild to moderate disability with impaired postural reflexes; physically independent) divided into: H&Y<3 (mild PD symptoms) and H&Y>3 (moderate to severe PD symptoms). According to the Schwab and England Activities of Daily Living (ADL) Scale patients were divided into 3 groups: ADL 80-100% (mild mobility impairment), ADL 60-79% (moderate mobility impairment) and ADL <60% (severe mobility impairment). According to the Montgomery-Asberg Depression Rating Scale (MADRS) for depression evaluation, there were 3 groups: MADRS<19 (mild depression), MADRS 10-20 (moderate depression) and MADRS >20 (severe depression).

Results: There were 12 patients <55 years, 16 patients aged 55-65 years and 32 patients were >65 years. There were 24 patients with H&Y<3 and 36 patients with H&Y>3. The majority of patients with H&Y>3 were categorised in the group of elderly patients (22 patients >65 years). Patients with H&Y<3 were diagnosed with mild (14 patients) or moderate (10) depression, while the patients with H&Y>3 had mild (4), moderate (24 ) or severe (8) depression. According to the ADL scale, out of 60 patients, 10 patients had mild, 22 patients had moderate and 28 patients had severe mobility impairment. Patients with the mild mobility impairment demonstrated mild (12 patients), moderate (8) or severe (2) depression, while patients with the severe imobility have had moderate (22  patients) or severe depression.

Conclusion: The results show that depression correlate with PD progression and it is mainly related to the disability.
Although, depression is the most common comorbidity in PD but often under-diagnosed in routine neurological practice therefore implying interdisciplinary management of PD patient as necessity.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/depression-in-patients-with-parkinsons-disease/