Problem
Depression is a common non-motor symptom in PD, affecting up to 35% of patients. However, depression in PD is often under-diagnosed and under-treated, with only 20% of diagnosed patients receiving treatment globally.
Methods
A retrospective audit was conducted on clinic letters from the outpatient PD clinic at Osborne Park Hospital over six months (January 2024 – June 2024).
Results
A total of 58 patients were audited. Depression was documented in 20.7% (n=12) of patients, with 5.2% (n=3) having comorbid anxiety and depression, and 8.6% (n=5) having anxiety alone. Mood was explicitly discussed in 70.7% (n=41) of consultations, with 24.1% (n=14) reporting low mood and 46.6% (n=27) denying symptoms, while 29.3% (n=17) had no mood discussion documented.
Geriatric Depression Scale (GDS) used as screening tool and completed in 24.1% (n=14) of patients, with an average score of 5.5, indicating clinically significant depressive symptoms. 68.1% (n=15) of patients with documented depression were prescribed antidepressants, while 31.8% (n=7) remained untreated. Notably, 8.6% (n=5) of patients were prescribed Mirtazapine without a documented mood disorder.
Conclusion
The prevalence of depression in our PD clinic (37%) aligns with global estimates. However, inconsistent documentation and low screening rates suggest that some cases may remain undiagnosed. Despite global concerns of under-treatment, our audit indicates a higher treatment rate (68.1%).
Re-Audit
These findings highlight the need to incorporate routine screening, improved documentation, and clinician confidence in prescribing antidepressants. A 12-month re-audit will assess the impact of these interventions on depression recognition and management in the PD clinic.