DEPRESSION IN PARKINSON'S DISEASE: THE DETERMINING ROLE OF DISEASE STAGE AND MOTOR DEFICIT

Abstract

Introduction. Depression is a frequent non-motor manifestation of Parkinson's disease (PD), significantly affecting patients' quality of life and prognosis. The aim of the study the prevalence of depression using the HADS scale and its associations with clinical and demographic parameters in PD patients. Materials and Methods. A total of 153 PD patients were examined. The assessment tools included Part III of the Unified Parkinson's Disease Rating Scale (UPDRS-III) for motor evaluation and the Hospital Anxiety and Depression Scale (HADS) for depression screening. Patients were categorized based on HADS scores into groups: no depression (0-7), subclinical depression (8-10), and clinical depression (≥11). Results and Discussion. Subclinical depression was identified in 68.6% (n=105) of patients, while clinical depression was found in 9.9% (n=15). Age and gender did not differ significantly between the groups (p>0.05). Strong positive correlations were established between the depression score and the Hoehn & Yahr stage (p=0.00043) as well as the UPDRS-III score (p=0.002). In the multivariate regression model, the PD stage was a borderline significant predictor of clinical depression (p=0.065). Conclusions. Depression in PD is predominantly subclinical and is strongly associated with the severity of motor deficit and disease stage. This justifies the rationale for implementing stage-oriented screening for depression in this patient population.