Friday, October 03, 2008
depression en vasculaire situatie
Medscape from WebMD
www.medscape.com
To Print: Click your browser's PRINT button.
NOTE: To view the article with Web enhancements, go to:
http://www.medscape.com/viewarticle/581256
Publication Logo
Late-Life Depression May Have a Vascular Etiology
Reuters Health Information 2008. © 2008 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
NEW YORK (Reuters Health) Oct 02 - Vascular depression is a subtype of late-life depression, characterized by deep white matter lesions evident on MRI, investigators report in the September 15th issue of Biological Psychiatry.
To evaluate features associated with late-life vascular depression, Dr. Joel R. Sneed, at Columbia University in New York, and his associates analyzed data from two clinical trials: the prospective Neurocognitive Outcomes of Depression in the Elderly (NCODE) study (367 subjects age 60 or older) and the Old-Old study, an 8-week study that compared the antidepressant citalopram with placebo in 174 subjects age 75 or older.
Their analyses showed that in both cohorts there were two classes of subjects, with samples approximately evenly split between the two classes. Those classified as vascular depression scored high for deep white matter and subcortical gray matter lesions, late-onset depression, and executive dysfunction. Nonvascular depression was associated with low scores for each factor.
Across both cohorts, deep white matter lesions had perfect sensitivity (1.00) and near perfect specificity (0.95) for vascular depression, the investigators report. Corresponding sensitivity and specificity were 0.61 and 0.77 for subcortical grey matter lesions, 0.33 and 0.84 for executive dysfunction, and 0.69 and 0.54 for late-onset depression.
Dr. Sneed's group notes that "patients with deep white matter hyperintensity burden might also present with cognitive deficits, falls, gait disturbance, and urinary incontinence without depressed mood or anhedonia. Thus, vascular depression may be viewed as part of a larger category of cerebral white matter lesion syndrome."
The researchers therefore concluded that "while deep white matter lesion burden is necessary to receive a diagnosis of vascular depression, our confidence in the accuracy of the classification increases with the presence of additional indicators."
Biol Psychiatry 2008;64:491-497.
www.medscape.com
To Print: Click your browser's PRINT button.
NOTE: To view the article with Web enhancements, go to:
http://www.medscape.com/viewarticle/581256
Publication Logo
Late-Life Depression May Have a Vascular Etiology
Reuters Health Information 2008. © 2008 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
NEW YORK (Reuters Health) Oct 02 - Vascular depression is a subtype of late-life depression, characterized by deep white matter lesions evident on MRI, investigators report in the September 15th issue of Biological Psychiatry.
To evaluate features associated with late-life vascular depression, Dr. Joel R. Sneed, at Columbia University in New York, and his associates analyzed data from two clinical trials: the prospective Neurocognitive Outcomes of Depression in the Elderly (NCODE) study (367 subjects age 60 or older) and the Old-Old study, an 8-week study that compared the antidepressant citalopram with placebo in 174 subjects age 75 or older.
Their analyses showed that in both cohorts there were two classes of subjects, with samples approximately evenly split between the two classes. Those classified as vascular depression scored high for deep white matter and subcortical gray matter lesions, late-onset depression, and executive dysfunction. Nonvascular depression was associated with low scores for each factor.
Across both cohorts, deep white matter lesions had perfect sensitivity (1.00) and near perfect specificity (0.95) for vascular depression, the investigators report. Corresponding sensitivity and specificity were 0.61 and 0.77 for subcortical grey matter lesions, 0.33 and 0.84 for executive dysfunction, and 0.69 and 0.54 for late-onset depression.
Dr. Sneed's group notes that "patients with deep white matter hyperintensity burden might also present with cognitive deficits, falls, gait disturbance, and urinary incontinence without depressed mood or anhedonia. Thus, vascular depression may be viewed as part of a larger category of cerebral white matter lesion syndrome."
The researchers therefore concluded that "while deep white matter lesion burden is necessary to receive a diagnosis of vascular depression, our confidence in the accuracy of the classification increases with the presence of additional indicators."
Biol Psychiatry 2008;64:491-497.
# posted by roodbont @ 3:27 PM 
