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    Contrary to what most folks think-including doctors-the severity of Parkinson's symptoms and effects of medications do not impact nearly as much on a patient's quality-of-life as the depression that often goes with this disease.

    A huge international study, The Global Parkinson Disease Survey (GPDS), surveyed 1,000 Parkinson's patients, 200 clinicians, and almost 700 caregivers, using several different questionnaires to measure health status and quality-of-life.

    At the International Conference on Parkinson Disease in Vancouver recently, the researchers presented their initial findings: Depression has an overwhelming impact on quality-of-life among patients with the disease. Although reliable depression measures indicated that 50 percent of the patients were clinically depressed, only one percent of patients and two percent of caregivers reported that patients were affected by depression. "This discrepancy highlights the fact that depression is not easily recognized in Parkinson's disease, even by the patient's caregiver," noted one of the researchers.

    Two other factors that had a big impact on quality-of-life were patient optimism and satisfaction with the way their doctors explained Parkinson's when it was first diagnosed. "Physicians need to be aware of the importance of the first consultation with the patient," a researcher noted. "In addition, they need to support patient optimism throughout the course of treatment."

    The researchers hope that understanding what influences quality-of-life will help in developing better treatments for Parkinson's disease. In the meantime, they called for research on how best to treat depression in these patients, and urged doctors to expand the routine management approach to identify and treat depression in these patients. "Monitoring and treatment of depression should become routine in Parkinson patients," they concluded.



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