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What a neurologist should know about depression in Parkinson’s disease
  1. Monique H M Timmer1,2,3,
  2. Maria H C T van Beek1,
  3. Bas R Bloem2,3,
  4. Rianne A J Esselink2,3
  1. 1 Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
  2. 2 Department of Neurology and Parkinson Center, Radboud University Medical Center, Nijmegen, The Netherlands
  3. 3 Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
  1. Correspondence to Dr Monique H M Timmer, Radboud university medical center, Department of Neurology (HP 935), PO Box 9101, 6500 HB Nijmegen, The Netherlands; monique.timmer{at}


Depression is a frequent non-motor symptom of Parkinson’s disease. Its prevalence varies widely across studies (between 2.7% and 90%); around 35% have clinically significant depressive symptoms. Although depression can have an immense impact on the quality of life of affected patients and their caregivers, depressive symptoms in Parkinson’s disease frequently remain unrecognised and, as a result, remain untreated. Here we overview the diagnostic challenges and pitfalls, including the factors contributing to the underdiagnosis of depression. We also discuss current ideas on the underlying pathophysiology. Finally, we offer a treatment approach based on currently available evidence.

  • parkinsons’s diesease
  • depression

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  • Contributors All authors contributed equally to this manuscript and approved the final version.

  • Funding This work was funded by a grant from the “Stichting Parkinson Fonds”, Hoofddorp, The Netherlands.

  • Competing interests BRB currently serves as Associate Editor for the Journal of Parkinson’s Disease, has received honoraria from serving on the scientific advisory board for Danone and Zambon, has received fees for speaking at conferences from AbbVie, Zambon and Teva and has received research support from the Netherlands Organization for Scientific Research, the Michael J Fox Foundation, the Prinses Beatrix Foundation, the Stichting Parkinson Fonds, the National Parkinson Foundation and the Parkinson Vereniging.

  • Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by Simon Lewis, Sydney, Australia.

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