Discordance Between Physician Assessment and Patient-Reported Depressive Symptoms in Parkinson Disease

Objective:To assess concordance between physician assessment and patient-reported symptoms when screening for depression in Parkinson disease (dPD). Background Depression in Parkinson disease is highly prevalent (approximate to 40%) and has a significant impact on quality of life and disability, yet physician recognition and treatment remain inadequate. Methods: One thousand seventy-six patients with PD completed the Brief Symptom Inventory-18 (BSI-18), a screening questionnaire for psychiatric symptoms, which was compared to item #3 (depression) on the Unified Parkinson's Disease Rating Scale (UPDRS). Results: The mean BSI-18 depression score was 51.4 (9.7). Of the 170 (16%) patients screening positive for dPD on the BSI-18, 104 (61%) were not recognized as depressed by neurologists on the UPDRS. Factors associated with lower neurologist recognition included male gender, better mental health quality of life, and lack of antidepressant use. Conclusion: More than 60% of patients screening positive for depression on self-report were not recognized by neurologists on the UPDRS. A patient-reported screening tool for depression may improve recognition and management of dPD.