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Depression and quality of life in monogenic compared to idiopathic, early-onset Parkinson's disease§

Authors

  • Meike Kasten MD,

    Corresponding author
    1. Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
    2. Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
    • Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
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  • Lena Kertelge MD,

    1. Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Vera Tadic MD,

    1. Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Norbert Brüggemann MD,

    1. Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Alexander Schmidt MD,

    1. Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Joyce van der Vegt MD,

    1. Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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  • Hartwig Siebner MD,

    1. Danish Research Center for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark
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  • Carsten Buhmann MD,

    1. Department of Neurology, University of Hamburg, Hamburg, Germany
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  • Rebekka Lencer MD,

    1. Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
    2. Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
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  • Kishore R. Kumar MD,

    1. Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
    2. Department of Neurogenetics, Kolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, Sydney, New South Wales, Australia
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  • Katja Lohmann PhD,

    1. Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Johann Hagenah MD,

    1. Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Christine Klein MD

    1. Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Funding agencies: This work was supported by EU grant GENEPARK (EU-LSHB-CT-2006-037544), MEFOPA, the NGFNplus (BMBF), the Volkswagen Foundation, the Hermann and Lilly Schilling Foundation, and the Hilde Ulrichs Foundation for Parkinson's Disease Research.

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Quality of life (QoL) is decreased in PD and is linked with depression and anxiety. However, little is known about QoL in monogenic PD. Subjects with mutations in PD genes were recruited from ongoing family and genetic studies (manifesting carriers, n = 23; nonmanifesting carriers, n = 19). For comparison purposes, we included patients with idiopathic PD (IPD; n = 128; early onset, n = 38; late onset, n = 90), healthy controls (n = 127), and data on depressive symptoms of 144 patients with major depression (treated controls). Depression affected 31% of early-onset PD cases, 21% of late-onset cases, and 44% of manifesting carriers of mutations in PD genes, but was rare in the nonmanifesting carriers (7%) and healthy controls (5%). Subjects with Parkinson-associated depression reported fewer feelings of guilt or self-doubt than treated controls, but the occurrence of suicidal ideation was associated with severity of depression only. Social phobia (P = 0.018) and agoraphobia (P = 0.059) were more common in manifesting carriers than in any other group. QoL was decreased in the Parkinson groups, particularly in the early-onset cases (P < 0.001), and QoL correlated with depression in all analyses. In our study, monogenic and IPD cases were comparable in QoL and depression characteristics. The QoL and, possibly, overall prognosis of all PD patients can be improved by appropriate attention and treatment for depression, sleep impairments, and anxiety, even if the treatment of the motor problems cannot be further optimized. © 2012 Movement Disorder Society

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