Analysis of factors associated with treatment-resistant depression in patients with depression in Parkinson's disease (DPD)

To investigate the factors associated with treatment-resistant depression (TRD) in patients with depression in Parkinson's disease (DPD) and provide a reference for early warning and intervention.

Clinical data from 156 DPD patients were retrospectively analyzed. Patients with a 17-item Hamilton Depression Rating Scale (HAMD-17) reduction rate≤20% after antidepressant treatment were classified into the Parkinson's disease with treatment-resistant depression (PD-TRD) group; the remaining DPD patients constituted the control group. Univariate analysis was performed for preliminary screening of associated factors. Binary logistic regression was used to further establish a predictive model. The accuracy of the predictive model was evaluated using receiver operating characteristic (ROC) curve analysis.

The incidence of PD-TRD was 55.8%. Univariate analysis indicated that sleep disorders, age, disease duration, UPDRS Part II score, UPDRS Part III score, economic income, education level, and exercise might be associated with PD-TRD. The logistic regression model ultimately incorporated six factors: sleep disorders (OR = 16.450), longer disease duration (OR = 1.245), higher UPDRS Part III score (OR = 8.829), higher economic income (OR = 0.206), better education level (OR = 0.318), and exercise (OR = 0.265). The area under the ROC curve (AUC) using sleep disorder was 0.703. The AUC using the predicted probability from the regression model was 0.911.

The incidence of TRD is high among DPD. Sleep disorders, longer disease duration, and higher UPDRS Part III scores are risk factors for TRD in DPD, while higher economic income, better education level, and exercise are protective factors. sleep disorders alone have moderate predictive value for PD-TRD in DPD.