Neurologists Tend to Underdiagnose Depression and Cognitive Problems in Patients With Parkinson’s Disease
Non-motor symptoms in Parkinson’s Disease (PD) generally tend to be under-diagnosed compared to motor problems. Some studies have compared different instruments to diagnose cognitive impairment (CI) and depression in PD, but few have studied how accurate the diagnostic process is in normal daily practice. A new study in BMC Neurology, compared neurologists assessments versus validated tests for depression and/or CI. Neurological consultations are often too short for formal validated tests for depression or CI to be administered, thus, it is an implicit diagnostic process for these non-motor symptoms.
A group of 104 patients diagnosed with Parkinson’s disease, were asked to complete a Hamilton Depressing Rating Scale and the Scales for Outcomes in Parkinson’s Disease-Cognition. The results were compared to neurology specialists who were asked to record if they thought the patient was depressed and if CI was present. There was no communication between the raters on this decision. They were also asked to reach an independent clinical diagnosis, and record it.
Results demonstrated that intuition and clinical judgment are not enough for a neurologist to recognize depression and/or cognitive problems in patients with recent-onset Parkinsonian syndromes. The authors pointed out that “it is important to realize this, considering the consequences of untreated depression and CI. Our neurologists missed more than half of the patients in diagnosing CI and depression.”