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Left-sided Parkinson's disease is associated with greater anxiety and depression

Published online by Cambridge University Press:  09 July 2009

S. Fleminger*
Affiliation:
Department of Psychiatry, Institute of Psychiatry, London
*
1 Address for correspondence: Dr S. Fleminger, Maudsley Hospital, Denmark Hill, London SE5 8AZ.

Synopsis

Seventeen patients with Parkinson's disease which was markedly asymmetric and worse on the right side of the body (RHP) were compared with 13 patients whose signs were worse on the left (LHP). The two groups of patients were well matched for age, duration of symptoms, disability, overall severity of signs, and medication.

The mean scores on ratings of depression, using both a self-rating scale and semi-structured interview rating, were almost twice as great in the LHP group. The LHP group also had significantly more symptoms of anxiety. The prevalence of clinically significant psychopathology was increased about five fold in the LHP group compared with the RHP group.

There was a close correlation between anxiety and depressive symptoms. The depression experienced by the patients was ‘atypical’, with relatively little anhedonia and evidence of a negative view of self, and prominent symptoms of anxiety. The best predictor of symptoms of depression and anxiety was a measure of social support and stress. They also correlated with the overall severity of Parkinson's disease.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1991

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References

Agid, Y., Javoy-Agid, F. & Ruberg, M. (1987). Biochemistry of neurotransmitters in Parkinson's disease. In Movement Disorders 2 (ed. Marsden, C. D. and Fahn, S.), pp. 166230. Butterworths: London.Google Scholar
Annett, M. (1970). A classification of hand preference by association analysis. British Journal of Psychology 61, 303321.CrossRefGoogle ScholarPubMed
Barber, J., Tomer, R., Sroka, H. & Myslobodsky, M. S. (1985). Does unilateral dopamine deficit contribute to depression? Psychiatry Research 15, 1724.CrossRefGoogle ScholarPubMed
Barolin, G. S., Bernheimer, H. & Hornykiewicz, O. (1964). Seitenverschiedenes verhalten des Dopamins (3-Hydroxytyramin) im Gehirn eines Falles von Hemiparkinsonismus. Schweizer Archiv für Neurologie, Neurochirurgie und Psychiatrie 94, 241248.Google Scholar
Bebbington, P., Hurry, J., Tennant, C., Sturt, E. & Wing, J. K. (1981). Epidemiology of mental disorders in Camberwell. Psychological Medicine 11, 561579.CrossRefGoogle ScholarPubMed
Beck, A. T. (1970). Depression. University of Pennsylvania Press: Philadelphia.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.CrossRefGoogle ScholarPubMed
Berger, P. A., Faull, K. F., Kilkowski, J., Anderson, P. J., Kreamer, H., Davis, K. L. & Barchas, J. D. (1980). CSF monoamine metabolites in depression and schizophrenia. American Journal of Psychiatry 137, 174180.Google ScholarPubMed
Blessed, G., Tomlinson, B. E. & Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry 114, 797812.CrossRefGoogle ScholarPubMed
Coffey, C. E. (1987). Cerebral laterality and emotion: the neurology of depression. Comprehensive Psychiatry 28, 197219.CrossRefGoogle ScholarPubMed
Fibiger, H. C. (1984). The neurobiological substrates of depression in Parkinson's disease: a hypothesis. Canadian Journal of Neurological Sciences 11, 105107.CrossRefGoogle ScholarPubMed
Folstein, M. F., Maiberger, R. & McHugh, P. R. (1977). Mood disorder as a specific complication of stroke. Journal of Neurology, Neurosurgery and Psychiatry 40, 10181020.CrossRefGoogle ScholarPubMed
Gainotti, G. (1972). Emotional behaviour and hemispheric side of lesion. Cortex 8, 4155.CrossRefGoogle ScholarPubMed
Garnett, E. S., Nahmias, C. & Firnau, G. (1984). Central dopaminergic pathways in hemiparkinsonism examined by positron emission tomography. Canadian Journal of Neurological Sciences 11, 174179.CrossRefGoogle ScholarPubMed
Gotham, A. M., Brown, R. G. & Marsden, C. D. (1986). Depression in Parkinson's disease: a quantitative and qualitative analysis. Journal of Neurology, Neurosurgery and Psychiatry 49, 381389.CrossRefGoogle ScholarPubMed
Grafman, J., Vance, S. C., Weingartner, H., Salazar, A. M. & Amin, D. (1986). The effects of lateralised frontal lessions on mood regulation. Brain 109, 11271148.CrossRefGoogle Scholar
Hoehn, M. M. & Yahr, M. D. (1967). Parkinsonism: onset, progression and mortality. Neurology 17, 427442.CrossRefGoogle ScholarPubMed
Horn, S. (1974). Some psychological factors in Parkinsonism. Journal of Neurology, Neurosurgery and Psychiatry 37, 2731.CrossRefGoogle ScholarPubMed
Jenkins, R., Mann, A. H. & Belsey, E. (1981). The background, design and use of a short interview to assess social stress and support in research and clinical settings. Social Science and Medicine 15, 195203.Google Scholar
Leenders, K. L., Salmon, E. P., Tyrrell, P., Perani, D., Brooks, D. J., Sagar, H., Jones, T., Marsden, C. D. & Frackowiak, R. S. J. (1991). The nigrostriatal dopaminergic system assessed in-vivo by positron emission tomography in healthy volunteers and patients with Parkinson's disease. Archives of Neurology (in the press).Google Scholar
MacCarthy, B. & Brown, R. (1989). Psychosocial factors in Parkinson's disease. British Journal of Clinical Psychology 28, 4152.CrossRefGoogle ScholarPubMed
Mayeux, R., Stern, Y., Cote, L. & Williams, J. B. W. (1984). Altered serotonin metabolism in depressed patients with Parkinson's disease. Neurology 34, 642646.CrossRefGoogle ScholarPubMed
Mindham, R. H. S. (1970). Psychiatric syndromes in Parkinsonism. Journal of Neurology, Neurosurgery and Psychiatry 30, 188191.CrossRefGoogle Scholar
Nelson, H. E. (1982). National Adult Reading Test (NART) for the Assessment of Premorbid Intelligence in Patients with Dementia: Test Manual. NFER-Nelson: Windsor.Google Scholar
Parkes, J. D., Zilkha, K. J., Calver, D. M. & Knill-Jones, R. P. (1970). Controlled trial of amantidine hydrochloride in Parkinson's disease. Lancet i, 259262.CrossRefGoogle Scholar
Reiman, E. M., Raichle, M. E., Butler, F. K., Hersovitch, P. & Robins, E. (1984). A focal brain abnormality in panic disorder, a severe form of anxiety. Nature 310, 683685.CrossRefGoogle ScholarPubMed
Robins, A. H. (1976). Depression in patients with Parkinsonism. British Journal of Psychiatry 128, 141145.CrossRefGoogle ScholarPubMed
Robinson, R. G., Kubos, K. L., Starr, L. B., Rao, K. & Price, T. R. (1984). Mood disorders in stroke patients: importance of location of lesion. Brain 107, 8193.CrossRefGoogle ScholarPubMed
Ross, E. D. & Rush, A. J. (1981). Diagnosis and neuroanatomical correlates of depression in brain damaged patients. Archives of General Psychiatry 38, 13441354.CrossRefGoogle ScholarPubMed
Schiffer, R. B., Kurlan, R., Rubin, A. & Boer, S. (1988). Evidence for atypical depression in Parkinson's disease. American Journal of Psychiatry 145, 10201022.Google ScholarPubMed
Sinyor, D., Jacques, P., Kaloupek, D. G., Becker, R., Goldenberg, M. & Coopersmith, H. (1986). Post-stroke depression and lesion location: an attempted replication. Brain 109, 537546.CrossRefGoogle Scholar
SPSS/PC (1988). Statistical Package for the Social Sciences V2.0. SPSS Inc.: Chicago.Google Scholar
Taylor, P. J., Dalton, R., Fleminger, J. J. & Lishman, W. A. (1982). Differences between two studies of hand preference in psychiatric patients. British Journal of Psychiatry 140, 166173.CrossRefGoogle ScholarPubMed
Tucker, D. M., Watson, R. T. & Heilman, K. M. (1977). Discrimination and evocation of affectively intoned speech in patients with right parietal disease. Neurology 27, 947950.CrossRefGoogle ScholarPubMed
van Praag, H. M. & Korf, J. (1971). Retarded depression and dopamine metabolism. Psychopharmacology 19, 199203.CrossRefGoogle Scholar
Willner, P. (1983). Dopamine and depression: a review of recent evidence. 1. Empirical studies. Brain Research 287, 211224.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: London.Google Scholar
Wing, J. K., Nixon, J. M., Mann, S. A. & Leff, J. P. (1977). Reliability of the PSE (ninth edition) used in a population survey. Psychological Medicine 7, 505516.CrossRefGoogle Scholar
Wing, J. K., Mann, S. A., Leff, J. P. & Nixon, J. M. (1978). The concept of a ‘case’ in psychiatric population surveys. Psychological Medicine 8 203218.CrossRefGoogle ScholarPubMed
Wing, J. K., Babor, T., Brugha, T., Burke, J., Cooper, J. E., Giel, R., Jablenski, A., Regier, D. & Sartorius, N. (1990). SCAN: schedule for clinical assessment in neuropsychiatry. Archives of General Psychiatry 47, 589593.CrossRefGoogle ScholarPubMed