Detecting depression in Parkinson disease: A systematic review and meta-analysis

doi:10.1212/WNL.0000000000002898

Review

. 2016 Jul 26;87(4):426-37.

doi: 10.1212/WNL.0000000000002898. Epub 2016 Jun 29.

Detecting depression in Parkinson disease: A systematic review and meta-analysis

Zahra Goodarzi¹, Kelly J Mrklas², Derek J Roberts², Nathalie Jette², Tamara Pringsheim², Jayna Holroyd-Leduc²

Affiliations

¹ From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada. zahra.goodarzi@albertahealthservices.ca.
² From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada.

PMID: 27358339
PMCID: PMC4977107
DOI: 10.1212/WNL.0000000000002898

Review

Detecting depression in Parkinson disease: A systematic review and meta-analysis

Zahra Goodarzi et al. Neurology. 2016.

. 2016 Jul 26;87(4):426-37.

doi: 10.1212/WNL.0000000000002898. Epub 2016 Jun 29.

Authors

Zahra Goodarzi¹, Kelly J Mrklas², Derek J Roberts², Nathalie Jette², Tamara Pringsheim², Jayna Holroyd-Leduc²

Affiliations

¹ From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada. zahra.goodarzi@albertahealthservices.ca.
² From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada.

PMID: 27358339
PMCID: PMC4977107
DOI: 10.1212/WNL.0000000000002898

Abstract

Background: Failure to detect depression in patients with Parkinson disease (PD) can lead to worsened outcomes for patients and caregivers. Accurate identification of depression would enable practitioners to provide comprehensive care for their patients with PD.

Methods: Our objective was to examine the diagnostic accuracy of tools for detecting depression in adult outpatients with PD. We searched MEDLINE, PsycINFO, and EMBASE (inception to December 1, 2015), gray literature, and bibliographies of included studies. The pooled prevalence of depression across studies and diagnostic accuracy estimates were calculated using random-effects models. Diagnostic accuracy estimates were calculated across the best-reported cutoffs from each study and across specific cutoffs, when feasible.

Results: Out of 8,184 citations, 21 studies were included, evaluating 24 tools, with 4 amenable to meta-analysis. The pooled prevalence of major depression was 22.9% (95% confidence interval [CI] 18.1-27.7). The 15-item Geriatric Depression Scale (GDS-15) had a pooled sensitivity of 0.81 (95% CI 0.64-0.91) and specificity of 0.91 (95% CI 0.87-0.94). The most sensitive cutoff for the GDS-15 was 5 at 0.91 (95% CI 0.83-1.00). The Beck Depression Inventory I/Ia had a pooled sensitivity of 0.79 (95% CI 0.61-0.90) and specificity of 0.85 (95% CI 0.79-0.90). The Montgomery-Åsberg Depression Rating Scale yielded a pooled sensitivity of 0.77 (95% CI 0.69-0.83) and specificity of 0.92 (95% CI 0.79-0.97). The Unified Parkinson's Disease Rating Scale had a pooled sensitivity of 0.72 (95% CI 0.64-0.79) and specificity of 0.80 (95% CI 0.70-0.87). All estimates had heterogeneity.

Conclusions: There are several valid tools for detecting depression in patients with PD. Practitioners should choose one that fits their clinical practice.

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Figures

**Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram**

**Figure 2. Forest plots**
(A–D) Forest plots of sensitivity and specificity for the Geriatric Depression Scale, Beck Depression Inventory, Montgomery-Åsberg Depression Rating Scale, and Unified Parkinson's Disease Rating Scale.

See this image and copyright information in PMC

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References

1. Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson's disease: a systematic review and meta-analysis. Mov Disord 2014;29:1583–1590. - PubMed
1. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:617–627. - PMC - PubMed
1. Patten SB, Williams JV, Lavorato DH, Wang JL, McDonald K, Bulloch AG. Descriptive epidemiology of major depressive disorder in Canada in 2012. Can J Psychiatry 2015;60:23–30. - PMC - PubMed
1. Pachana NA, Egan SJ, Laidlaw K, et al. . Clinical issues in the treatment of anxiety and depression in older adults with Parkinson's disease. Mov Disord 2013;28:1930–1934. - PubMed
1. Reijnders JS, Ehrt U, Weber WE, Aarsland D, Leentjens AF. A systematic review of prevalence studies of depression in Parkinson's disease. Mov Disord 2008;23:183–189; quiz 313. - PubMed

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[1] Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson's disease: a systematic review and meta-analysis. Mov Disord 2014;29:1583–1590. - PubMed

[2] Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson's disease: a systematic review and meta-analysis. Mov Disord 2014;29:1583–1590. - PubMed

[3] Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:617–627. - PMC - PubMed

[4] Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:617–627. - PMC - PubMed

[5] Patten SB, Williams JV, Lavorato DH, Wang JL, McDonald K, Bulloch AG. Descriptive epidemiology of major depressive disorder in Canada in 2012. Can J Psychiatry 2015;60:23–30. - PMC - PubMed

[6] Patten SB, Williams JV, Lavorato DH, Wang JL, McDonald K, Bulloch AG. Descriptive epidemiology of major depressive disorder in Canada in 2012. Can J Psychiatry 2015;60:23–30. - PMC - PubMed

[7] Pachana NA, Egan SJ, Laidlaw K, et al. . Clinical issues in the treatment of anxiety and depression in older adults with Parkinson's disease. Mov Disord 2013;28:1930–1934. - PubMed

[8] Pachana NA, Egan SJ, Laidlaw K, et al. . Clinical issues in the treatment of anxiety and depression in older adults with Parkinson's disease. Mov Disord 2013;28:1930–1934. - PubMed

[9] Reijnders JS, Ehrt U, Weber WE, Aarsland D, Leentjens AF. A systematic review of prevalence studies of depression in Parkinson's disease. Mov Disord 2008;23:183–189; quiz 313. - PubMed

[10] Reijnders JS, Ehrt U, Weber WE, Aarsland D, Leentjens AF. A systematic review of prevalence studies of depression in Parkinson's disease. Mov Disord 2008;23:183–189; quiz 313. - PubMed

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Detecting depression in Parkinson disease: A systematic review and meta-analysis

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Detecting depression in Parkinson disease: A systematic review and meta-analysis

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