John C. Hemby
Parkinson’s disease has affected people from different walks of life, from the poor to the famous, i.e. Michael J. Fox. These famous individuals are responsible for putting forward momentum in the study and cure of the disease. Statistics show that 1 million Americans are currently diagnosed with this disease, not to include those that are living undiagnosed (Piccinni, et al., 2012). Parkinson’s is defined as a progressive movement disease. This means that disease becomes worse and worse over time. This disease destroys the nerve cells in the brain and affects mostly in the area called the substantia nigra (Kalat, 2012, p. 255). The neurons that die happened to have controlled movement, thus as the disease gets worse mobility and control decreases as well. There is no particular found cause yet and there is no cure, only medication and or surgery that will assist in managing the symptoms (Piccinni, et al., 2012). However, according to the text, a group of young adults were exposed to a drug similar to heroine and developed Parkinson’s disease (Kalat, 2012, p. 255). The substance responsible was called MPTP, which essentially destroys the neurons that produce dopamine. These researchers decided to look into the neuropsychiatry of this disease and determine if a depressive state or symptoms of depression implied a greater amount of disability to those that had Parkinson’s. The researchers’ names are Piccinni, Marazziti, Veltri, Ceravolo, Ramacciotti, Carlini, Del Debbio, Schiavi, Bonuccelli, and Dell’Osso. They conducted their research in 2012 and the title of the article they published was called, “Depressive Symptoms in Parkinson’s”.
The researchers hypothesized that Parkinson’s and depression are linked together; that the more progressive or worse the disease was, the higher level of depression or symptoms of depression could be observed (Piccinni, et al., 2012). This study was conducted in order to gain a better understanding between the areas of the brain that Parkinson’s affected and depression. They started this study by enlisting the aid of 122 patients from the department of Neuroscience at Pisa University in Italy. There wasn’t an age limit and the study included 70 men participants and 52 women participants. All participants gave full consent to the study and the study itself was approved by a local ethics committee. The researchers utilized the Hamilton Rating Scale for Depression or HRSD to assess the participants’ level of depression (Piccinni, et al., 2012). Last, there wasn’t any compensation for the completion of the study.
The participants had to be assessed first by a neurologist. This was done with the Unified Parkinson’s disease Rate Scale or UPDRS. The UPDRS is the standard by which all motor movement is measured in people with Parkinson’s. The Scale contains four parts; the first part is mentation, behavior and mood, the second area is activities of daily living, the third area is motor examination and the last part is complications of therapy (Piccinni, et al., 2012). However, the researchers only used parts II and III of the UPDRS. The higher the score meant the more severe or progression of the disease. Also, during this study, all participants went through a psychiatric evaluation. The HRSD was then used to evaluate the seriousness of the participants’ depression. This tool is most effective and is recommended, especially for participants who have Parkinson’s disease (Piccinni, et al., 2012). The scores for HRSD are as follows; from 8-17 an individual has mild depression, a score from 18-24 suggests that the individual has moderate depression and anything with the score of 25 or higher is severely depressed.
The results of the study indicated that the hypothesis was correct; that there was a positive correlation between participants who had Parkinson’s and depression, meaning that the worse or more progressive an individual’s Parkinson’s disease was, the worse the depression or symptoms of depression. The data was analyzed utilizing post-hoc ANOVAS (Piccinni, et al., 2012). The findings showed that 24% of the participants had mild depression, 25% had a moderate level of depression and 5% having severe depression. The participants who had severe depression also scored high on the UPDRS, which meant their motor skills were highly impaired, and the same with the participants who had moderate levels of depression (Piccinni, et al., 2012).
The conclusion of this study shows a positive correlation between Parkinson’s disease and depression. This also shows that motor disability and depression are uniquely intermingled and further study should be conducted. Future research now knows of another way to indicate how far an individual’s progression of their Parkinson’s disease, especially if it is severely impairing their motor capability (Piccinni, et al., 2012). There were several issues with this study. First, the researchers only used individuals that were already in a neurology department; they should expand their recruiting area in order to receive other participants who may be receiving different forms of treatment. The second issue is that this study was conducted as a cross-sectional study. An improvement would to see if the correlation continued in the individuals who had mild depression to see if their depression worsened as their Parkinson’s progressed. Last, there was an issue with the different types of medications the participants were taking; this could have had an effect on their depression.
There are some different ways for this subject to be studied different in the future. The first approach would be to see the difference between those who haven’t been treated for Parkinson’s and those who have in order to see if the levels of depression would differentiate any. The next idea is that according to the text, middle aged adults who drink coffee continuously had a dramatic decrease in the likelihood of Parkinson’s disease (Kalat, 2012, p. 256). Coffee is also used to decrease levels of depression as well; so, for a longitudinal study, one could utilize twins; one that drank coffee and the other who did not and see if there was a definite correlation between Parkinson’s, coffee and depression. The last idea would see if the varying medications utilized to treat Parkinson’s disease could affect the level of depression as well. So, for a future research study, an individual could separate the three top medicines utilized to treat the symptoms of Parkinson’s and see if they also affected depression.
Kalat, James W. Biological Psychology, 11th Edition. Cengage Learning, 01/2012. VitalBook file.
Piccinni, A., Marazziti, D., Veltri, A., Ceravolo, R., Ramacciotti, C., Carlini, M., Dell’Osso, L. (2012). Depressive symptoms in parkinson’s disease. Comprehensive Psychiatry, 53(6), 727-31. doi:http://dx.doi.org/10.1016/j.comppsych.2011.11.002