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      Prevalência de depressão na doença de Parkinson Translated title: Prevalence of depression in Parkinson's disease

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          Abstract

          CONTEXTO: O reconhecimento da prevalência da depressão em pacientes com doença de Parkinson (DP) é necessário para o desenvolvimento de práticas direcionadas ao tratamento da depressão e a melhora na qualidade de vida deles. OBJETIVO: Identificar na literatura indexada estudos relacionados à prevalência de depressão na DP, visto que normalmente há sub-reconhecimento e subdiagnóstico da comorbidade. MÉTODOS: Levantamento de artigos no PubMed, LILACS e SciELO que cumpriram com as palavras-chave: prevalence, depression e Parkinson. Critérios para inclusão: artigos nos idiomas inglês, português e espanhol, sem limite de tempo. Excluíram-se artigos relacionados ao tratamento da DP e validação de escalas. RESULTADOS: Selecionaram-se 20 artigos com taxas de prevalência de depressão de 1,8% a 68,1%. Seis estudos foram casos-controle, dois foram coortes, um, longitudinal prospectivo e 13, transversais. Quanto à técnica de avaliação, oito empregaram entrevista clínica, nove utilizaram apenas instrumentos de auto-avaliação, um empregou entrevista clínica e instrumentos de auto-avaliação e quatro consultaram bancos de dados. CONCLUSÕES: A prevalência de depressão variou de acordo com a metodologia, porém, em geral, as taxas foram bastante elevadas. Evidenciou-se a necessidade de definições mais precisas sobre depressão na DP para se estabelecer uma taxa de prevalência mais acurada.

          Translated abstract

          BACKGROUND: The recognition of depression prevalence in Parkinson's disease (PD) is necessary for the development of treatment techniques as well as the improvement in the patient's quality of life. OBJECTIVE: To identify in the literature studies related to the prevalence of depression in PD. METHODS: The search for articles was based on PubMed, LILACS and SciELO matching the key-words prevalence, depression and Parkinson. Inclusion criteria of articles were: papers in English, Portuguese and Spanish; without time limitation. Articles related to the treatment of PD and to the validation of scales were excluded. RESULTS: A total of 20 studies were selected, including six case-control studies, 3 longitudinal (2 cohort) studies, and 43 non-sectional studies. Prevalence rates ranged from 1.8% to 68.1%. Concerning the evaluation of techniques employed, eight studies used clinical interviews, nine used just self-report instruments, one utilized clinical interviews and self-report instruments and four consulted data bases. DISCUSSION: The prevalence of depression varied according to the methodology, however, in general, rates proved to be considerably elevated. The analysis reveals the necessity of more precise and consensual definitions regarding depression in PD so that more accurate prevalence rates can be obtained.

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          Most cited references28

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          Depression in neurological disorders: Parkinson's disease, multiple sclerosis, and stroke.

          H Rickards (2005)
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            The occurrence of depression in Parkinson's disease. A community-based study.

            To investigate the frequency of major depression (MD) and the severity of depressive symptoms among patients with Parkinson's disease (PD). The PD population was derived from a community-based prevalence study. Total case ascertainment and a high diagnostic accuracy of PD were attempted through a detailed community study and the use of a new clinical diagnostic classification. Major depression was diagnosed according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. The severity of depression in the prevalence population was scored with the Montgomery and Asberg Depression Rating Scale. The occurrence of depressive symptoms among patients with PD was compared with the occurrence among age-matched groups of patients with diabetes mellitus and of healthy elderly. In addition, the patients with PD and the control groups completed the Beck Depression Inventory. Depression among patients with PD derived from a prevalence study in the county of Rogaland, Norway. Two hundred forty-five patients with PD. Two age-matched control groups (each including 100 patients); one group included patients with diabetes mellitus and the other, healthy elderly. Of the 245 patients with PD, 7.7% met the criteria for MD. Based on their Montgomery and Asberg Depression Rating score, 5.1% of the patients were moderately to severely depressed whereas another 45.5% had mild depressive symptoms. Among the patients who scored 20 or more on the Mini-Mental State Examination, 3.6% had MD compared with 25.6% of the patients with a score below 20. The frequency of patients with a Beck Depression Inventory score of 18 or more was higher in the PD group (24.1%) than among patients with diabetes mellitus (11%) and the healthy elderly controls (4%). This study suggests that the prevalence of MD in PD is lower than previously assumed, but a substantial proportion of patients with PD have less severe depressive symptoms.
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              An estimate of the incidence of depression in idiopathic Parkinson's disease.

              Estimates of the prevalence of depression in idiopathic Parkinson's disease vary, but have been greater than in most comparison groups. In a survey of patients with Parkinson's disease (N = 339), the prevalence of depression was 47%. A total of 326 cases were reviewed to estimate the incidence of depression from September 30, 1984, to July 31, 1989. Assessments of depression during both the prevalent and the incident periods were noted in 258 cases. There was no history of depression in 129 cases, and nine new cases occurred. The incidence rate was 1.86% per year and the cumulative risk was 8.6%. Published estimates of the incidence of depression in the general population are few. In one study, the annual incidence of depression in individuals older than 40 years was 0.17%. In another, the incidence of depression in individuals older than 50 years was 0.14% for men and 0.29% for women. Although our retrospective study probably underdiagnoses depression, the incidence of depression is increased in Parkinson's disease.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rpc
                Archives of Clinical Psychiatry (São Paulo)
                Arch. Clin. Psychiatry (São Paulo)
                Faculdade de Medicina da Universidade de São Paulo (São Paulo )
                1806-938X
                2008
                : 35
                : 6
                : 219-227
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Universidade de São Paulo Brazil
                [3 ] Universidade de São Paulo Brazil
                [4 ] Universidade de São Paulo Brazil
                [5 ] Universidade de São Paulo Brazil
                Article
                S0101-60832008000600003
                10.1590/S0101-60832008000600003
                06fc52e4-9d6d-42ea-90d8-99a22d5b7ccf

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0101-6083&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL
                PSYCHIATRY

                Internal medicine,Clinical Psychology & Psychiatry
                Prevalence,depression,Parkinson,Prevalência,depressão

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