Journal Mobile Options
Table of Contents
Vol. 36, No. 5, 2003
Issue release date: September–October 2003

Psychopathological Symptoms of Depression in Parkinson’s Disease Compared to Major Depression

Merschdorf U. · Berg D. · Csoti I. · Fornadi F. · Merz B. · Naumann M. · Becker G. · Supprian T.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Parkinson’s disease is frequently associated with depressive symptoms. When depression occurs at early stages and before the onset of characteristic motor symptoms of the disease, differential diagnosis of major depression may be difficult. Differences in psychopathological features of depression in Parkinson’s disease and major depression have been reported by some authors. This study presents data of 49 patients with depression in Parkinson’s disease and 38 patients with major depression. The severity of depressive symptoms was equivalent in both groups. Depressive features did not differ between the two groups with exception of affective flattening, delusional ideas and suicide attempts. In conclusion, this investigation gives support to the assumption of a common neurobiological origin of depression in Parkinson’s disease and major depression.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Schiffer RB, Kurlan R, Rubin A, Boer S: Evidence for atypical depression in Parkinson’s disease. Am J Psychiatry 1988;145:1020–1022.
  2. Ehmann TS, Beninger RJ, Gawel MJ, Riopelle RJ: Depressive symptoms in Parkinson’s disease: A comparison with disabled control subjects. J Geriatr Psychiatry Neurol 1990;3:3–9.
  3. Cummings JL: Depression in Parkinson’s disease: A review. Am J Psychiatry 1992;149:443–454.
  4. Menza MA, Robertson-Hoffman DE, Bonapace AS: Parkinson’s disease and anxiety. Biol Psychiatry 1993;34:465–470.
  5. Tandberg E, Larsen JP, Aarsland D, Cummings JL: The occurrence of depression in Parkinson’s disease. Arch Neurol 1996;53:175–179.
  6. Stefanova N, Seppi K, Scherfler C, Puschban Z, Wenning GK: Depression in α-synucleinopathies: Prevalence, pathophysiology and treatment. J Neural Transm 2000;60:335–343.
  7. Slaughter JR, Slaughter KA, Nichols D, Holmes SE, Martens MP: Prevalence, clinical manifestation, etiology and treatment of depression in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 2001;13:187–196.
  8. Gotham AM, Brown RG, Marsden CD: Depression in Parkinson’s disease: A quantitative and qualitative analysis. J Neurol Neurosurg Psychiatry 1986;49:381–389.
  9. Brown RG, MacCarthy B: Psychiatric morbidity in patients with Parkinson’s disease. Psychol Med 1990;20:77–87.
  10. Kuzis G, Sabe L, Tiberti C, Leiguarda R, Starkstein SE: Cognitive function in major depression and Parkinson disease. Arch Neurol 1997;54:982–986.
  11. Cantello R, Aguggia M, Gilli M, Delsedime M, Chiardo Dutin I, Ricco A, Mutani R: Major depression in Parkinson’s disease and the mood response to intravenous methylphenidate: Possible role of the ‘hedonic’ dopamine synapse. J Neurol Neurosurg Psychiatry 1989;52:724–731.
  12. Becker G, Struck U, Bogdahn U, Becker T: Echogenicity of the brainstem raphe in patients with major depression. Psychiatry Res 1994;55:75–84.
  13. Becker G, Becker T, Struck M, Lindner A, Burzer K, Retz W, Bogdahn U, Beckmann H: Reduced echogenicity of brainstem raphe specific to unipolar depression: A transcranial color-coded real-time sonography study. Biol Psychiatry 1995;38:180–184.
  14. Becker T, Becker G, Seufert J, Hofmann E, Lange KW, Naumann M, Lindner A, Reichmann H, Riederer P, Beckman H, Reiners K: Parkinson’s disease and depression: Evidence for an alteration of the basal limbic system detected by transcranial sonography. J Neurol Neurosurg Psychiatry 1997;63:590–596.
  15. Berg D, Supprian T, Hofmann E, Zeiler B, Jäger A, Lange KW, Reiners K, Becker T, Becker G: Depression in Parkinson’s disease: Brainstem midline alteration on transcranial sonography and magnetic resonance imaging. J Neurol 1999;246:1186–1193.
  16. Ring HA, Bench CJ, Trimble MR, Brooks DJ, Frackowiak RS, Dolan RJ: Depression in Parkinson’s disease – A positron emission study. Br J Psychiatry 1994;165:333–339.
  17. Collier DA, Stöber G, Li T, Heils A, Catalano M, Di Bella D, Arranz MJ, Murray RM, Vallada HP, Bengel D, Muller CR, Roberts GW, Smeraldi E, Kirov G, Sham P, Lesch KP: A novel functional polymorphism within the promoter of the serotonin transporter gene: Possible role in susceptibility to affective disorders. Mol Psychiatry 1996;1:453–460.
  18. Gutierrez B, Pintor L, Gasto C, Rosa A, Bertranpetit J, Vieta E, Fananas L: Variability in the serotonin transporter gene and increased risk for major depression with melancholia. Hum Genet 1998;103:319–322.
  19. Lesch KP, Mössner R: Genetically driven variation in serotonin uptake: Is there a link to affective spectrum, neurodevelopmental and neurodegenerative disorders. Biol Psychiatry 1998;44:179–192.
  20. Mössner R, Henneberg A, Schmitt A, Syagailo YV, Grässle M, Hennig T, Simantov R, Gerlach M, Riederer P, Lesch KP: Allelic variation of serotonin transporter expression is associated with depression in Parkinson’s disease. Mol Psychiatry 2001;6:350–352.
  21. Chia LG, Cheng LJ, Chuo LJ, Cheng FC, Cu JS: Studies of dementia, depression, electrophysiology and cerebrospinal fluid monoamine metabolites in patients with Parkinson’s disease. J Neurol Sci 1995;133:73–78.
  22. Leonard BE: The role of noradrenalin in depression: A review. J Psychopharmacol 1997;11:39–47.
  23. Schildkraut JJ: Neuropharmacology of affective disorders. Annu Rev Psychopharmacol 1973;13:427–454.
  24. Goodwin FK, Post RM, Dunner DL, Gordon EK: Cerebrospinal fluid amine metabolites in affective illness. The probenecid technique. Am J Psychiatry 1973;130:73–79.
  25. American Psychiatric Association: Diagnostic and Statistical Manual Of Mental Disorders, ed 4. Washington, APA, 1995.
  26. Ward D, Gibb WR: Research criteria for Parkinson’s disease; in Streifler MB, Korzyn AD, Melamed E, Youdim MBH (eds): Parkinson’s Disease: Anatomy, Pathology and Therapy. Adv Neurol 1990;53:245–249
  27. Fahn S, Elton RL and Members of the UPDRS Development Committee: Unified Parkinson’s disease rating scale; in Fahn S, Marsden CD, Goldstein M et al (eds): Recent Developments in Parkinson’s Disease. II. New York, Macmillan, 1987, pp 153–163.
  28. Hamilton M: A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62.
  29. Leentjens AF, Verhey FR, Lousberg R, Spitsbergen H, Wilmink FW: The validity of the Hamilton and Montgomery-Asberg depression rating scales as screening and diagnostic tools for depression in Parkinson’s disease. Int J Geriatr Psychiatry 2000;15:644–649.
  30. Beck AT, Ward CJ, Mendelsohn M, Mock H, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–571.
  31. Richter P, Werner J, Heerlein A, Kraus A, Sauer H: On the validity of the Beck Depression Inventory. Psychopathology 1998;31:160–168.
  32. Leentjens AF, Verhey FR, Luijckx GJ, Troost J: The validity of the Beck Depression Inventory as a screening instrument for depression in patients with Parkinson’s disease. Mov Disord 2000;15:1221–1224.
  33. Zerssen D, Köller DM: Die Befindlichkeitsskala. Manual. Weinheim, Beltz, 1976.
  34. Overall JE, Hollister LE, Pichot P: Major psychiatric disorders: A four-dimensional model. Arch Gen Psychiatry 1967;16:146–151.
  35. Collegium Internationale Psychiatriae Scalarum: Rating Scales for Psychiatry. Weinheim, Beltz, 1990.
  36. Franz M, Lemke MR, Meyer T, Ulferts J, Puhl P, Snaith RP: Deutsche Version der Snaith-Hamilton Pleasure Scale. Fortschr Neurol Psychiatr 1998;66:407–413.
  37. Starkstein SE, Mayberg HS, Leiguarda R, Preziosi TJ, Robinson RG: A prospective longitudinal study of depression, cognitive decline and physical impairments in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1992;55:377–382.
  38. Oertel WH, Höglinger GU, Caraceni T, Girotti F, Eichhorn T, Spottke AE, Krieg JC, Peowe W: Depression in Parkinson’s disease. An update; in Calne D, Calne S (eds): Parkinson’s Disease. Adv Neurol 2001;86:373–383.
  39. Birkmayer W, Riederer P: Biological Aspects of Depression in Parkinson’s Disease. Psychopathology 1986;19(suppl 2):58–61.
  40. Baumann B, Danos P, Diekmann S, Bilau H, Gerecke N, Bernstein HG, Bogerts B: Postmortem analysis of noradrenergic and serotonergic brainstem systems in mood disorders. Eur Arch Psychiatry Clin Neurosci 1998;248(suppl 2):79.
  41. Baumann B, Danos P, Krell D, Diekmann S, Wurthmann C, Bielau H, Bernstein HG, Bogerts B: Unipolar-bipolar dichotomy of mood disorders is supported by noradrenergic brainstem system morphology. J Affect Disord 1999;54:217–224.
  42. Becker G, Berg D, Lesch KP, Becker T: Basal limbic system alteration in major depression: A hypothesis supported by transcranial sonography and MRI findings. Int J Neuropsychopharmacol 2001;4:21–31.
  43. Brown RG, MacCarthy B, Gotham AM, Der RJ, Marsden CD: Depression and disability in Parkinson’s disease: A follow-up study of 132 cases. Psychol Med 1988;18:49–55.
  44. Henderson R, Kurlan R, Kersun J, Como P: Preliminary examination of the comorbidity of anxiety and depression in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 1992;4:257–264.
  45. Starkstein SE, Preziosi TJ, Bolduc PL, Robinson RG: Depression in Parkinson’s disease. J Nerv Ment Dis 1990;178:27–31.
  46. Myslobodsky M, Lalonde FM, Hicks L: Are patients with Parkinson’s disease suicidal? J Geriatr Psychiatry Neurol 2001;4:120–124.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50