Objective: To determine the impact of systematic survey-based screening for depression on treatment outcomes in people with Parkinson’s disease (PD) in a clinical practice setting.

Background: Depression in PD and has a profound impact on disability, quality of life, and medication-based care. However, it is often undertreated. Previously, we implemented universal screening for depression as part of a larger study which successfully increased rates of depression screening. However, treatment rates remained low with 23% of patients initiating treatment (1).

Method: This is a retrospective chart review of people with PD (PwP) seen at the University of Pennsylvania Movement Disorders Center from 6/27/2021 to 7/1/2023. Participants completed the Geriatric Depression Scale-15 (GDS-15) as part of their pre-visit check-in process. We included those who had at least two visits with completed GDS scores with the first score > 4 (positive screen). We abstracted sociodemographic and clinical data from the chart including documentation of depression and initiation of medication, psychotherapy, and watchful waiting as treatment options. Descriptive and bivariate analyses were performed. Future multivariate analyses will be conducted on a larger sample.

Results: 50 PwP (52% male, mean [SD] age of 70.1 [8.9] years and disease duration 8.9 [7.9] years) were included. 62% had prior depressive symptoms and 32% were already on medication. Clinicians assessed for any mood symptoms in 82% of charts. However, only 28% specifically mentioned the GDS-15 score. In 14% of cases there was a medication change, 26% a non-medication recommendation, and watchful waiting in 8% of cases. 52% of cases did not have a plan for their depression. In cases where depression was documented by the clinician, 21% had a medication change vs. 0% when depression was not documented (p=0.041) and 36% had a non-medication recommendation vs. 5.9% when depression was not documented (p=0.020).

Conclusion: Unfortunately, systematic screening for depression using the GDS-15 did not result in widespread utilization of this score or treatment changes. However, clinicians who documented depression in their note were more likely to recommend an intervention. More work is needed to determine how to best implement screening measures to ensure clinician engagement and, ultimately, improve patient outcomes.

References: 1. Marras C, Meyer Z, Liu H, Luo S, Mantri S, Allen A, Baybayan S, Beck JC, Brown AE, Cheung F, Dahodwala N, Davis TL, Engeland M, Fearon C, Jones N, Mills K, Miyasaki JM, Naito A, Neault M, Nelson EC, Onyinanya E, Ropa C, Weintraub D. Improving Parkinson’s Disease Care through Systematic Screening for Depression. Mov Disord Clin Pract. 2024 Oct;11(10):1212-1222. doi: 10.1002/mdc3.14163. Epub 2024 Jul 19. PMID: 39030949; PMCID: PMC11489616.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-systematic-survey-based-screening-for-depression-in-parkinsons-disease/