Hubungan stadium penyakit parkinson dengan skor tingkat depresi

NURYANI, Dewi Tri, dr. Moh. Wasan, Sp.S(K)

2009 | Tesis | S2 Ilmu Kedokteran Klinik

Komplikasi non motorik terbanyak pada penyakit Parkinson (PP) adalah depresi, dengan prevalensi 7-76%. Prevalensi depresi pada PP masih inkonsisten, disebabkan karena jumlah sampel, metoda penelitian dan alat ukur yang digunakan berbeda. Gejala depresi sering tumpang tindih dengan gejala PP sehingga kurang mendapat perhatian para klinisi. Depresi dapat memperburuk aktivitas harian penderita PP. Hipotesis pada penelitian ini adalah stadium III lebih banyak mengalami depresi dibanding stadium I dan II serta skor depresi berat lebih banyak terjadi pada stadium III dibanding stadium I dan II. Penelitian ini menggunakan studi potong lintang, dengan uji perbandingan untuk pasien PP rawat jalan di poliklinik saraf RSUP. Dr. Sardjito Yogyakarta, RSUD. dr. Soeradji Tirtonegoro Klaten, dr. Saras Husada Purworejo, dan RSUD. Wates. Sampel diambil secara berurutan dan diwawancarai menggunakan kuesioner terstruktur, Mini Mental State Examination untuk menyingkirkan demensia, dan Hamilton Rating Scale for Depression (HRSD). Terdapat 66 pasien PP memenuhi kriteria inklusi dan berdasarkan Hoen and Yahr Staging, diperoleh stadium I, II dan III. Sebanyak 32 (48,5%) pasien mengalami depresi, 43,8% diantaranya mengalami depresi ringan, 15,6% sedang dan 40,6% berat. Skor depresi berat lebih sering didapatkan pada stadium III dibanding stadium I dan II (88,9%), sedangkan skor depresi ringan lebih sering didapatkan pada stadium I-II dibanding III (72,2%), p<0,05. Tidak ada perbedaan antara skor depresi sedang dan berat antara stadium I-II dibanding III (p>0,05). Pada analisis dengan regresi logistik terhadap semua variabel, didapatkan tidak ada perbedaan antara stadium PP dengan depresi. Depresi dapat terjadi pada semua stadium PP. Depresi berat lebih sering didapatkan pada stadium III dibanding I dan II. Stadium PP dapat mempengaruhi depresi pada PP tetapi tidak secara independen.

The most common non motoric complication in Parkinson’s Disease (PD) is depression. There were 7-76% depression in PD. The prevalence of depression is still inconsisten, caused by sample count, research methode and tool of depression. Symptoms of depression are often overlapping with symptoms of PD so often lack to get attention by clinission. Depression can make worsenning of activity daily living. Hypothesis of this study is the thirth staging of PD has depression more than other staging. The thirth staging is more often suffer from severe depression than the first and second staging. The study was designed as a Cross-sectional study, the research use proportional test for 66 outpatient PD in neurology policliclinic Dr. Sardjito hospital Jogjakarta, Dr. Soeradji Tirtonegoro hospital Klaten, dr. Saras Husada hospital Purworejo, and district hospital Wates. The research use the consecutive sampling. All of patient were interviewed with course quessioner, Mini Mental State Examination to eliminate dementia, and Hamilton Rating Scale for Depression (HRSD). Sixty six patients were included in this study. Based on the Hoen and Yahr Staging, there were staging I, II and III in this study. There were 32 (48,5%) patients suffer from depression, these were 43,8% suffer from mild depression, 15,6% moderate and 40,6% severe. Severe depression is bigger at the staging III than staging I and II (88,9%), while mild depression is bigger at the staging I-II than III (72,2%), p<0,05. No difference for moderate and severe depression beetwen staging I-II than III (p>0,05). In the logistic regression, there were not significant value among the staging PD and other variables. Depression can occure for all of staging PD. Severe depression is more occure at staging III PD than staging I and II. Depression was significant value with staging PD but not independently.

Kata Kunci : Stadium penyakit,Parkinson,Skor tingkat depresi,Potong lintang,staging Parkinson disease, skor depression, cross-sectional