Objective To investigate the clinical features and risk factors of depression in newly diagnosed untreated people with Parkinson disease (PD). Methods The data of a total of 218 newly diagnosed untreated PD patients in dyskinesia outpatient of Neurology Department of Affiliated Nanjing Brain Hospital, Nanjing Medical University from October 2010 to December 2019 and 171 age- and gendermatched healthy controls were retrospectively collected. The Unified PD Rating Scale (UPDRS) Part Ⅱ, Ⅲ and Ⅴ were used to examine the motor symptoms of PD patients. The PD Sleep Scale (PDSS), Montreal Cognitive Assessment Scale (MoCA) and Non-Motor Symptom Quest (NMSQ) were used to assess nonmotor symptoms in PD patients. The degree of depression and anxiety in PD group and control group were evaluated using the 24-item Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). The incidence rate and clinical data were compared between the PD and control groups. The clinical symptoms of PD patients with depression (dPD) and those without depression (n-dPD) were compared. Multivariate Logistic regression was used to analyze the risk factors of depression in newly diagnosed and untreated PD patients. Results The HAMD score of PD group was 8.0 (4.0,13.0), and the incidence of dPD was 12.4% (27/218), with 5 cases of mild depression, 18 cases of moderate depression, and 4 cases of severe depression. The HAMD score of control group was 2.0 (0,2.0), and the rate of depressive episode was 6.4% (11/171), with 5 cases of mild depression, 5 cases of moderate depression, and 1 case of severe depression. The differences in severity and incidence rate of depression between the two groups were statistically significant (P < 0.05). The total score of HAMD-24 and each factor score, HAMA score and NMSQ score in dPD group were higher than those in n-dPD group. The proportion of patients in early stage, with aberrant posture instability and gait difficulty (PIGD) subtype in dPD group was higher than that in n-dPD group. The scores of UPDRS-Part Ⅱ and PDSS in dPD group were lower than those in n-dPD group (P< 0.05). High HAMA score (OR=1.167, 95%CI=1.077-1.265), high NMSQ score (OR=1.235, 95%CI=1.052-1.449), and PIGD subtype (OR=2.024, 95%CI=1.053-3.891) were the risk factors of dPD. High PDSS score was the protective factor of dPD (OR=0.971, 95%CI=0.945-0.997) (P < 0.05). Conclusions The depression of newly diagnosed PD patients was mainly moderate depression. PD patients with anxiety, more non-motor symptoms, poor sleep quality and PIGD subtype were more likely to suffer from depression.
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华平,李丽,张洪燕,姚燕,于翠玉,刘卫国.初诊未服药帕金森病患者的抑郁特点及危险因素 分析[J].神经疾病与精神卫生,2022,22(10): DOI :10.3969/j. issn.1009-6574.2022.10.005.