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Attitudes Regarding the Etiology and Treatment of Depression in Parkinson's Disease: A Qualitative Study

Department of Psychiatry, University of Pennsylvania

Frances K. Barg, PhD

Department of Family Medicine and Community Health, University of Pennsylvania, Department of Anthropology, School of Arts and Sciences (FKB), University of Pennsylvania, Philadelphia, Pennsylvania

Gregory K. Brown, PhD

Department of Psychiatry, University of Pennsylvania

Donna Taraborelli, BA

Department of Psychiatry, University of Pennsylvania

Matthew B. Stern, MD

Parkinson's Disease, Philadelphia VA Medical Center

Daniel Weintraub, MD

Department of Psychiatry, University of Pennsylvania, Department of Neurology, University of Pennsylvania, Parkinson's Disease, Philadelphia VA Medical Center, Mental Illness Research, Education, and Clinical Centers (PADRECC and MIRECC), Philadelphia VA Medical Center, Pennsylvania, weintrau{at}mail.med.upenn.edu

Depression in Parkinson's disease (dPD) remains under recognized and under treated. As patients' beliefs may impact the reporting and treatment of depression, this study assessed the opinions of 38 dPD patients, approximately half with a self-reported poor response to antidepressant treatment, regarding the etiology and treatment of their depression using a semi-structured, audio-taped, qualitative interview. About half of the participants listed PD itself as a primary cause for their depressive symptoms, with most in this group citing psychosocial factors rather than PD-related neurobiological factors. Antidepressant therapy, psychotherapy, and self-initiated approaches were noted as preferred treatments for dPD. Many had concerns about antidepressant therapy, listing side-effects and medication dependency most frequently. About half raised concerns about psychotherapy with trust/discomfort, stigma, and transportation issues most frequently mentioned. This preliminary study suggests that many PD patients with clinically significant depressive symptoms attribute their depression to psychosocial factors and endorse nonpharmacologic treatment approaches.

Key Words: Parkinson's disease • depression • antidepressant • psychotherapy • qualitative interview

Journal of Geriatric Psychiatry and Neurology, Vol. 21, No. 2, 123-132 (2008)
DOI: 10.1177/0891988708316862


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