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DOI: 10.1177/0891988704267456 Depression in Parkinsons Disease: Conceptual Issues and Clinical ChallengesDepartment of Psychiatry, Maastricht University Hospital, P.O. Box 5800, 6202 AZ Maastricht, the Netherlandsa.leentjens{at}np.unimaas.nl Background: Depression frequently accompanies Parkinsons disease (PD) and may have a negative impact on activities of daily living, cognitive performance, and quality of life. Because of the symptom overlap between the 2 disorders, it may be difficult to recognize depression in PD. Moreover, the partially shared pathophysiology may make it difficult to treat depressive symptoms without influencing motor or cognitive function. Objective: To review the current knowledge of the epidemiology, etiology, pathophysiology, and treatment of depression in patients with Parkinsons disease. Method: Discussion of recent studies and relevant literature. Conclusion: Not only conceptually but also in terms of etiology, pathophysiology, and treatment, the relationship between PD and depression remains a challenge. There are still many questions to be answered. In the therapeutic domain, large, placebo-controlled trials are necessary to evaluate the efficacy of antidepressant treatment and allow the development of evidence-based guidelines. (J Geriatr Psychiatry Neurol 2004; 17:120-126)
Key Words: Parkinsons disease depression
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