Abstract Details

Title Discordance between Physician Assessment and Patient-Reported Depressive Symptoms in Parkinson's Disease

Topic Movement Disorders

Presentation(s) S03 - (-)

Poster/Presentation
Number 002

Objective

Background Depression is common in PD, affecting approximately 40% of patients in cross-sectional studies. However, physician recognition of depression in PD is inadequate.

Design/Methods A sample of 1076 PD patients completed a self-reported screening questionnaire for psychiatric symptoms (BSI-18) which was compared to the physician evaluation, item #3 (depression) on the Unified Parkinson's Disease Rating Scale (UPDRS). Other patient-reported measures included quality of life (SF-12) and medical comorbidity (CIRS). A scaled score of T=60 on the BSI-18 (one standard deviation above the mean) and ?3 on the UPDRS depression item were used as cutoffs for dPD.

Results The patients (N=1076) average age was 65.7±11.0Y (62% male), and 22% were on an antidepressant. The mean BSI-18 depression score was 51.4±9.7. Of 26% (n=277) of PD patients screening positive for depressed mood on the BSI-18, 69% (n=190) were not recognized as depressed by neurologists on the UPDRS. Factors associated with a lower likelihood of recognizing depression by neurologists included: male gender (76% vs 45%, p<0.01), less medical comorbidity (6.0±3.7, 7.0±3.4, p<0.05); milder PD disease severity (UPDRS total 56.2±20.9, 49.6±21.0, p<0.01), better mental health quality of life (32.8±7.6, 40.5±8.5, p<0.01) and lack of antidepressant use (49% vs. 31%, p<0.01).

Conclusions Nearly 70% of patients who screened positive for depressed mood on self-report were not recognized as depressed by clinicians on the UPDRS depressed mood item during routine outpatient visits. This study demonstrates that use of patient-reported screening tests for depression has the potential to improve recognition of depression by treating physicians.

Authors/Disclosures
Richard Salazar, MD, FAAN (Jackson Hospital & Clinic) PRESENTER	No disclosure on file
Christian Lachner	Christian Lachner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PeerView.
Ann Gruber-Baldini	No disclosure on file
	No disclosure on file
Karen Anderson	No disclosure on file
Paul S. Fishman, MD, PhD (Univ of Maryland Sch of Med)	No disclosure on file
Stephen G. Reich, MD, FAAN (Univ of MD Hospital/Dept of Neuro)	Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Best Doctors. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UpToDate. Dr. Reich has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Reich has received research support from ninds. Dr. Reich has received publishing royalties from a publication relating to health care. Dr. Reich has received publishing royalties from a publication relating to health care.
William J. Weiner, MD	No disclosure on file
Melissa Armstrong, MD, MSc, FAAN, FAAN (UF Department of Neurology)	The institution of Dr. Armstrong has received research support from National Institute of Aging. The institution of Dr. Armstrong has received research support from Florida Department of Health. The institution of Dr. Armstrong has received research support from Lewy Body Dementia Association. Dr. Armstrong has received research support from Parkinson Foundation. Dr. Armstrong has received personal compensation in the range of $5,000-$9,999 for serving as a DSMB member with Alzheimer's Clinical Trials Consortium. Dr. Armstrong has received personal compensation in the range of $5,000-$9,999 for serving as a DSMB member with Alzheimer's Disease Cooperative Study. Dr. Armstrong has a non-compensated relationship as a Member, Scientific Advisory Council with Lewy Body Dementia Association that is relevant to AAN interests or activities.
Lisa M. Shulman, MD, FAAN (University of Maryland School of Medicine)	The institution of Dr. Shulman has received research support from NIH. Dr. Shulman has received publishing royalties from a publication relating to health care. Dr. Shulman has received publishing royalties from a publication relating to health care.

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