Depression: A Primary Symptom of Parkinson Disease?

By Silverman, Franklin H.; Henry, Barbara | The Journal of Rehabilitation, July-September 1989 | Go to article overview

Depression: A Primary Symptom of Parkinson Disease?


Silverman, Franklin H., Henry, Barbara, The Journal of Rehabilitation


Depression: A Primary Symptom of Parkinson Disease?

One of the most common neurological conditions present in geriatric clients who seek rehabilitation services is Parkinson disease. While there appears to be good agreement on the nature of its primary physical symptomatology -- i.e., tremor, rigidity, and bradykinesia -- this is not the case for its primary psychological symptomatology (Dakof & Mendelsohn, 1986). There is considerable disagreement about whether chronic depression occurs frequently enough to be considered a primary symptom of the disease, and if it does, whether its cause is mainly biochemical or psychosocial. A high incidence of chronic depression among persons who have this disease -- regardless of whether its etiology were physiological or psychological--obviously would impact upon the activities of those responsible for planning and assessing rehabilitation services for such persons.

Traditionally, depression had been regarded as being as much a primary symptom of Parkinson disease as tremor, rigidity, and bradykinesia (Dakof and Mendelsohn, 1986; Gotham, Brown, and Marsden, 1986; Horn, 1974; Robins, 1976; Santamaria, Tolosa, and Valles, 1986). This may have been due, in part, to the fact that persons who are depressed and those who have Parkinson disease tend to share the following symptoms: slowness in movement, stooped posture, blank facial expression, sleep disturbances, and slowness in cognitive functioning. The findings of several recent studies suggest that chronic depression is not a primary symptom of Parkinson disease--i.e., they suggest that the majority of persons who have the disease are not chronically depressed (Dakof and Mendelsohn, 1986; Santamaria, Tolosa, and Valles, 1986). A study is reported in this paper the findings of which are consistent with this conclusion.

Method

Fifty-two persons who had Parkinson disease, who were members of the Wisconsin Parkinson Association, completed a semantic differential task (Osgood, Suci, & Tannenbaum, 1957). The majority of the participants were male (70 percent) and married (81 percent). The participants ranged in age from 45 to 83 years (mean - 68 years) and the mean length of time they had had Parkinson disease was eight years (range 2 to 25 years). The majority (65 percent) of them were retired.

Participants were instructed to rate themselves on each of 81 seven-point, bipolar adjectival scales with regard to how well the adjectives that defined the scale described them. The semantic differential used (Silverman, 1985, pp. 258-259) was designed for eliciting stereotypes of persons who had communicative disorders. We decided to use this semantic differential because it included a depressed/happy scale, and since it contained so many scales, participants would be unlikely to infer the purpose of our study (i.e., to determine whether the majority of persons with Parkinson disease are depressed) from examining it. Each scale was presented in this form: depressed - - - - - happy.

The semantic differential task was administered using a standard set of instructions (Silverman, 1985, pp. 256-257).

Results

Three percentages were computed for each scale: the percentage of participants whose ratings were at one of the two poles (i.e., the percentage who placed a mark on one of the three lines at the right or left side of the scale) and the percentage of participants whose ratings were at the center of the scale. The majority of the participants did not judge themselves to be depressed. Only nine of the 52 (17 percent) revealed by their ratings on the depressed/happy scale that they were depressed: A chi square test (Siegel, 1956) indicated that the probability of this outcome being due to chance is less than 0.01. These data suggest that chronic depression is not experienced by the majority of persons with Parkinson disease who are similar to our subjects and, hence, it is not a primary symptom of Parkinson disease for such persons. …

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