Use of the GDS-15 geriatric depression scale as a screening instrument fordepressive symptomatology in patients with Parkinson's disease and their carers in the community

Objectives: to assess the level of depressive symptomatology in a community based group of patients with Parkinson's disease (PD) and their carers and to investigate the patient characteristics that might predict carer distre ss. Methods: the GDS-15 geriatric depression scale was used to measure self-rat ed depressive symptoms in a group of 132 subjects with clinically probable PD randomly selected from a community-based disease register. Disease sever ity was assessed by the Webster scale and cognitive function by the CAMCOG test. Carers of the patients, who in this study were all spouses, were also asked to complete the GDS-15. Results: a total of 64% of our group of patients and 34% of carers scored w ithin the 'depressed' range on the GDS-15. Patients with high levels of dep ressive symptoms tended to have more severe disease, disease of longer dura tion and more impaired cognitive function. The GDS score of the carer was b est predicted by the GDS score of the patient being cared for. Less than 10 % of patients and carers were being treated with antidepressant medication. Conclusions: this community-based study confirms the high level of depressi ve symptoms in PD suggested by hospital- and clinic-based studies. Depressi on in patients appears to be related to disease severity and cognitive impa irment. An important determinant of carer distress and mood disorder, as re flected by the GDS score, appears to be the level of depression expressed b y the patient being cared for. Despite high levels of depressive symptoms i n both patients and carers, very few subjects were in receipt of antidepres sant drug therapy.