INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #93 Prevalence of Depression in Parkinson’s Disease Candidates for Deep Brain Stimulation Surgery: Overlap Between Formal Psychiatric Diagnoses and Self-Report Mood Scales Rachel Schade, University of Florida, Gainesville, United States Katie Rodriguez, University of Florida, Gainesville, United States Adrianna Ratajska, University of Florida, Gainesville, United States Lauren Kenney, University of Florida, Gainesville, United States Justin Hilliard, University of Florida, Gainesville, United States Kelly Foote, University of Florida, Gainesville, United States Herbert Ward, University of Florida, Gainesville, United States Uma Suryadevara, University of Florida, Gainesville, United States Dawn Bowers, University of Florida, Gainesville, United States Category: Movement and Movement Disorders Keyword 1: Parkinson's disease Keyword 2: depression Keyword 3: neuropsychiatry Objective: Depression affects between 30-40% of individuals with Parkinson’s disease (PD), with symptom severity often measured via self-report questionnaires. The goal of the current study was twofold: a) to learn which psychiatric diagnoses of depression are most common among PD patients who are candidates for deep brain stimulation (DBS) surgery and b) to learn how psychiatric diagnoses of clinical depression correspond to clinically elevated scores on a self-report scale, the Beck Depression Inventory-II (BDI-II). We hypothesized that Major Depressive Disorder (MDD) would be the most prevalent diagnosis in this population and that individuals with MDD would make up the greatest proportion of individuals who reported clinically significant depressive symptoms on the BDI-II. Participants and Methods: Participants included 403 individuals with idiopathic PD (mean age=65+9 years old; 72% male; 94% white), from a clinical convenience sample seen at the UF Fixel Institute for Neurological Diseases. All underwent interdisciplinary evaluation to determine candidacy for DBS. As part of their neuropsychological evaluation, all participants completed the BDI-II; standardized clinical cutoffs (BDI-II > 14) for PD determined clinically significant depressive symptoms. Within 1-3 days, the psychiatric team independently evaluated the same patients using the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5) diagnostic criteria. Psychiatrists were blinded to participants’ BDI-II scores. Results: Out of 403 PD participants, 25% (N=101) of this sample were diagnosed with a depressive disorder by a psychiatrist. Approximately half of those diagnosed with any depressive disorder (48.5%, N=49) reported clinically significant depressive symptoms on the BDI-II, significantly less than expected [χ2(1)=29.7, p <.001]. Major Depressive Disorder was the predominant depressive diagnosis among pre-DBS PD patients (N=50, 49.5%). Of those diagnosed with MDD, only 56% (n=28) endorsed significant depressive symptoms on the BDI-II. Following MDD, the top three depression diagnoses were: Other Specified Depressive Disorder (N=20; 40% above BDI-II cutoff), 2. Mood Disorder Due to Another Medical Condition with Depressive Features (N=14; 50% above BDI-II cutoff), and 3. Unspecified Depression, (N=9; 33% above BDI-II cutoff). The remaining 8 patients fell into categories of Adjustment Disorder (N=4), Bipolar Disorder (N=3), and Unspecified Mood Disorder (N=1). Conclusions: Consistent with our hypotheses, MDD was the predominant diagnosis among pre-DBS PD patients and had the largest proportion of clinically significant depression endorsements on the BDI-II. However, no more than half of individuals with a clinical diagnosis of depression reported clinically significant levels of depression on the BDI-II, regardless of type of depressive diagnosis. This discordance is likely multifactorial. First, self-report measures capture limited symptoms and are subject to patient interpretation. Second, clinical diagnostic interviews can result in more information of symptoms through detailed, targeted questioning. Third, there is difficulty disentangling nonmotor symptoms of PD and symptoms of depression (i.e., fatigue, poor sleep, decreased concentration) due to considerable overlap. Fourth, use of a standardized cutoff on the BDI-II fails to capture individuals who report levels of depression that do not reach clinical significance (i.e., score of 13 vs 14). The findings of this study emphasize the importance of the clinical interview to diagnose depressive disorders in PD.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #93

Prevalence of Depression in Parkinson’s Disease Candidates for Deep Brain Stimulation Surgery: Overlap Between Formal Psychiatric Diagnoses and Self-Report Mood Scales

Rachel Schade*, University of Florida, Gainesville, United States
Katie Rodriguez*, University of Florida, Gainesville, United States
Adrianna Ratajska, University of Florida, Gainesville, United States
Lauren Kenney, University of Florida, Gainesville, United States
Justin Hilliard, University of Florida, Gainesville, United States
Kelly Foote, University of Florida, Gainesville, United States
Herbert Ward, University of Florida, Gainesville, United States
Uma Suryadevara, University of Florida, Gainesville, United States
Dawn Bowers, University of Florida, Gainesville, United States

Category: Movement and Movement Disorders

Keyword 1: Parkinson's disease
Keyword 2: depression
Keyword 3: neuropsychiatry

Objective:

Depression affects between 30-40% of individuals with Parkinson’s disease (PD), with symptom severity often measured via self-report questionnaires. The goal of the current study was twofold: a) to learn which psychiatric diagnoses of depression are most common among PD patients who are candidates for deep brain stimulation (DBS) surgery and b) to learn how psychiatric diagnoses of clinical depression correspond to clinically elevated scores on a self-report scale, the Beck Depression Inventory-II (BDI-II). We hypothesized that Major Depressive Disorder (MDD) would be the most prevalent diagnosis in this population and that individuals with MDD would make up the greatest proportion of individuals who reported clinically significant depressive symptoms on the BDI-II.

Participants and Methods:

Participants included 403 individuals with idiopathic PD (mean age=65+9 years old; 72% male; 94% white), from a clinical convenience sample seen at the UF Fixel Institute for Neurological Diseases. All underwent interdisciplinary evaluation to determine candidacy for DBS. As part of their neuropsychological evaluation, all participants completed the BDI-II; standardized clinical cutoffs (BDI-II > 14) for PD determined clinically significant depressive symptoms. Within 1-3 days, the psychiatric team independently evaluated the same patients using the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5) diagnostic criteria. Psychiatrists were blinded to participants’ BDI-II scores.

Results:

Out of 403 PD participants, 25% (N=101) of this sample were diagnosed with a depressive disorder by a psychiatrist. Approximately half of those diagnosed with any depressive disorder (48.5%, N=49) reported clinically significant depressive symptoms on the BDI-II, significantly less than expected [χ2(1)=29.7, p <.001]. Major Depressive Disorder was the predominant depressive diagnosis among pre-DBS PD patients (N=50, 49.5%). Of those diagnosed with MDD, only 56% (n=28) endorsed significant depressive symptoms on the BDI-II. Following MDD, the top three depression diagnoses were: Other Specified Depressive Disorder (N=20; 40% above BDI-II cutoff), 2. Mood Disorder Due to Another Medical Condition with Depressive Features (N=14; 50% above BDI-II cutoff), and 3. Unspecified Depression, (N=9; 33% above BDI-II cutoff). The remaining 8 patients fell into categories of Adjustment Disorder (N=4), Bipolar Disorder (N=3), and Unspecified Mood Disorder (N=1).

Conclusions:

Consistent with our hypotheses, MDD was the predominant diagnosis among pre-DBS PD patients and had the largest proportion of clinically significant depression endorsements on the BDI-II. However, no more than half of individuals with a clinical diagnosis of depression reported clinically significant levels of depression on the BDI-II, regardless of type of depressive diagnosis. This discordance is likely multifactorial. First, self-report measures capture limited symptoms and are subject to patient interpretation. Second, clinical diagnostic interviews can result in more information of symptoms through detailed, targeted questioning. Third, there is difficulty disentangling nonmotor symptoms of PD and symptoms of depression (i.e., fatigue, poor sleep, decreased concentration) due to considerable overlap. Fourth, use of a standardized cutoff on the BDI-II fails to capture individuals who report levels of depression that do not reach clinical significance (i.e., score of 13 vs 14). The findings of this study emphasize the importance of the clinical interview to diagnose depressive disorders in PD.