Journal
BIOLOGICAL PSYCHIATRY
Volume 55, Issue 4, Pages 390-397Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2003.08.014
Keywords
depression; aged; MRI; cerebrovascular disease; diagnostic criteria
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Funding
- NIMH NIH HHS [P50 MH 60451, R01 MH 54846, K23 MH 65939] Funding Source: Medline
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Background: There is a substantial body of research supporting the vascular depression hypothesis of late-life depression. To update this hypothesis so it incorporates recent research, we propose that the term subcortical ischemic vascular depression may be a more accurate representation of the disease process. We sought to investigate this diagnosis as a construct by examining differences between depressed subjects with and without magnetic resonance imaging defined subcortical ischemic vascular depression. Methods. This case-control study examined 139 depressed elderly subjects. Demographic data, psychiatric, medical, and family history, depressive symptomatology, and functional impairment were compared between groups dichotomized based on neuroimaging findings. Results: Seventy-five (54%) of the subjects met neuroimaging criteria for subcortical ischemic vascular depression. Age was most strongly associated with increased prevalence of subcortical ischemic vascular depression. Lassitude and a history of hypertension were also positively associated with the diagnosis; a family history of mental illness and loss of libido were negatively associated with the diagnosis. Conclusions. These data support that subcortical ischemic vascular depression may be a specific syndrome from other types of late-life depression. Further research is needed to further characterize this disorder. particularly in regards to cognitive junction and treatment implications.
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