Depression comorbidity in spinocerebellar ataxia

Tanja Schmitz-Hübsch, Mathieu Coudert, Sophie Tezenas du Montcel, Paola Giunti, Robyn Labrum, Alexandra Dürr, Pascale Ribai, Perrine Charles, Christoph Linnemann, Ludger Schöls, Maryla Rakowicz, Rafal Rola, Elszbieta Zdzienicka, Roberto Fancellu, Caterina Mariotti, Lazlo Baliko, Bela Melegh, Alessandro Filla, Elena Salvatore, Bart P C van de WarrenburgSandra Szymanski, Jon Infante, Dagmar Timmann, Sylvia Boesch, Chantal Depondt, Jun Suk Kang, Jörg B. Schulz, Thomas Klopstock, Nicole Lossnitzer, Bernd Löwe, Caroline Frick, Daniela Rottländer, Thomas E. Schlaepfer, Thomas Klockgether

Research output: Contribution to journalArticlepeer-review

Abstract

This is a description of the prevalence and profile of depressive symptoms in dominant spinocerebellar ataxia (SCA). Depressive symptoms were assessed in a convenience sample of 526 genetically confirmed and clinically affected patients (117 SCA1, 163 SCA2, 139 SCA3, and 107 SCA6) using the Patient Health Questionnaire (PHQ). In addition, depressive status according to the examiner and the use of antidepressants was recorded. Depression self-assessment was compared with an interview-based psychiatric assessment in a subset of 26 patients. Depression prevalence estimates were 17.1% according to the PHQ algorithm and 15.4% when assessed clinically. The sensitivity of clinical impression compared with PHQ classification was low (0.35), whereas diagnostic accuracy of PHQ compared with psychiatric interview in the subset was high. Antidepressants were used by 17.7% of patients and in >10% of patients without current clinically relevant depressive symptoms. Depression profile in SCA did not differ from a sample of patients with major depressive disorder except for the movement-related item. Neither depression prevalence nor use of antidepressants differed between genetic subtypes, with only sleep disturbance more common in SCA3. In a multivariate analysis, ataxia severity and female sex independently predicted depressive status in SCA. The PHQ algorithmic classification is appropriate for use in SCA but should stimulate further psychiatric evaluation if depression is indicated. Despite a higher risk for depression with more severe disease, the relation of depressive symptoms to SCA neurodegeneration remains to be shown.

Original languageEnglish
Pages (from-to)870-876
Number of pages7
JournalMovement Disorders
Volume26
Issue number5
DOIs
Publication statusPublished - Apr 2011

Keywords

  • Cerebellum
  • Depression
  • Prevalence studies
  • Spinocerebellar ataxia

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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