Correlation between depressive symptoms and nocturnal disturbances in Japanese patients with Parkinson's disease

Suzuki, Keisuke; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Okuma, Yasuyuki; Hattori, Nobutaka; Kamei, Satoshi; Yoshii, Fumihito; Utsumi, Hiroya; Iwasaki, Yasuo; Iijima, Mutsumi; Hirata, Koichi

doi:10.1016/j.parkreldis.2008.02.002

« Previous Next »Parkinsonism & Related Disorders
Volume 15, Issue 1 , Pages 15-19, January 2009

Correlation between depressive symptoms and nocturnal disturbances in Japanese patients with Parkinson's disease

Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, 880-Kitakobayashi, Mibu, Tochigi 321-0293, Japan
- Corresponding author. Tel.: +81 282 86 1111x2723; fax: +81 282 86 5884.
Masayuki Miyamoto
- Department of Neurology, Dokkyo Medical University, 880-Kitakobayashi, Mibu, Tochigi 321-0293, Japan
Tomoyuki Miyamoto
- Department of Neurology, Dokkyo Medical University, 880-Kitakobayashi, Mibu, Tochigi 321-0293, Japan
Yasuyuki Okuma
- Department of Neurology, Juntendo University Shizuoka Hospital, Tokyo, Japan
Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
Satoshi Kamei
- Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
Fumihito Yoshii
- Department of Neurology, Tokai University School of Medicine, Kanagawa, Japan
Hiroya Utsumi
- Division of Neurology, Third Department of Internal Medicine, Tokyo Medical University, School of Medicine, Tokyo, Japan
Yasuo Iwasaki
- Department of Neurology, Toho University Omori Hospital, Tokyo, Japan
Mutsumi Iijima
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
Koichi Hirata
- Department of Neurology, Dokkyo Medical University, 880-Kitakobayashi, Mibu, Tochigi 321-0293, Japan

Received 10 November 2007; accepted 4 February 2008.

Abstract

Depression and nocturnal disturbances are frequent in patients with Parkinson's disease (PD). The aim of this study was to determine the correlation between depressive symptoms and nocturnal disturbances in patients with PD in Japan. The subjects of this multi-center cross-sectional study were 188 patients with PD and 144 age-matched controls who were assessed for nocturnal disturbances by the Parkinson's disease sleep scale (PDSS) and for depressive symptoms by Zung Self-Rating Depression Scale (SDS). Depressive symptoms (SDS score of ≥40) were identified in 122 patients (64.9%). The SDS was significantly higher in PD patients than control subjects. The stepwise regression model identified PDSS (p<0.001) and Unified Parkinson's Disease Rating Scale I (mental state) (p=0.002) as significant determinants of SDS. Stepwise regression analysis identified item 15 (daytime sleepiness) (p=0.002), item 13 (early morning tremor) (p=0.008), item 12 (nocturnal dystonia) (p=0.015), and item 3 (sleep maintenance insomnia) (p=0.026) as significant predictors of SDS. Our results indicated that depressive symptoms in PD correlate significantly with nocturnal disturbances, and that daytime sleepiness, dystonia, tremor and sleep fragmentation are the most common nocturnal disturbances in depressed patients with PD.