Provisional diagnostic criteria for depression in Parkinson's disease: Report of an NINDS/NIMH Work Group

Laura Marsh, William M. McDonald, Jeffrey Cummings, Bernard Ravina, Nancy Abraham, Debra J. Babcock, Kevin J. Black, David Burn, Peter Como, Jeffrey Cummings, Emmeline Edwards, Robin Elliott, Joseph Friedman, Katrina Gwinn-Hardy, Robert M. Hamer, Melinda Kelley, Bonnie Levin, Constantine G. Lyketsos, Jeffrey M. Lyness, Karen S. MarderMathew Menza, Lynn Morin, Peter Muehrer, Diane Murphy, Irene Richard, Paul Sheehy, Robert L. Spitzer, Sharon Stone, Brenda Tucker, Margaret Tuchman, Carol Walton, Daniel Weintraub, James R. Williams, Robert Zalutsky

Research output: Contribution to journalReview articlepeer-review

253 Scopus citations


Mood disorders are the most common psychiatric problem associated with Parkinson's disease (PD), and have a negative impact on disability and quality of life. Accurate diagnosis of depressive disturbances in PD is critical and will facilitate the testing and use of new interventions; however, there are no clear diagnostic criteria for depressive disorders in PD. In their current form, strict Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria are difficult to use in PD and require attribution of specific symptoms to PD itself or the depressive syndrome. Additionally, DSM criteria for major depression and dysthymia exclude perhaps half of PD patients with comorbid clinically significant depression. This review summarizes an NIH-sponsored workshop and describes recommended changes to DSM diagnostic criteria for depression for use in PD. Participants also recommended: (1) an inclusive approach to symptom assessment to enhance reliability of ratings in PD and avoid the need to attribute symptoms to a particular cause; (2) the inclusion of subsyndromal depression in clinical research studies of depression of PD; (3) the specification of timing of assessments for PD patients with motor fluctuations; and (4) the use of informants for cognitively impaired patients. The proposed diagnostic criteria are provisional and intended to be defined further and validated but provide a common starting point for clinical research in PD-associated depression.

Original languageEnglish
Pages (from-to)148-158
Number of pages11
JournalMovement Disorders
Issue number2
StatePublished - Feb 1 2006


  • Affective symptoms
  • Depression
  • Diagnosis
  • Mood disorders
  • Parkinson's disease


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