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Am J Psychiatry 1995; 152:37-44
Copyright © 1995 by American Psychiatric Association
Prevalence and correlates of dysthymia and major depression among patients with Alzheimer's disease
R Migliorelli, A Teson, L Sabe, M Petracchi, R Leiguarda and SE Starkstein
Department of Neuropsychiatry and Neuropsychology, Raul Carrea Institute of Neurological Research, Buenos Aires, Argentina.
OBJECTIVE: The purpose of this study was to examine the prevalence, risk
factors, and correlates of depression among patients with Alzheimer's
disease. METHOD: A consecutive series of 103 patients with probable
Alzheimer's disease were examined with a structured psychiatric interview
and were assessed for the presence of cognitive impairments, deficits in
activities of daily living, social functioning, and anosognosia. RESULTS:
Fifty-one percent of the patients had depression (28% had dysthymia and 23%
major depression). Women had a significantly higher prevalence of both
major depression and dysthymia than men. Depressed and nondepressed
patients had a similar frequency of family and personal histories of
depression, a similar frequency of personality disorders before the onset
of depression, and no significant differences in cognitive deficits and
impairment in activities of daily living. Dysthymia usually started after
the onset of dementia and was significantly more prevalent in the early
stages of dementia; patients with dysthymia had a significantly better
awareness of intellectual deficits than patients with major or no
depression. On the other hand, patients with major depression had an
earlier onset of depression (half of them before the onset of dementia),
and the prevalence of major depression was similar across the different
stages of the illness. CONCLUSIONS: This study demonstrates a high
prevalence of dysthymia and major depression among patients with probable
Alzheimer's disease. While dysthymia may be an emotional reaction to the
progressive cognitive decline, major depression may be related to
biological factors.
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