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Am J Psychiatry 1997; 154:562-565
Copyright © 1997 by American Psychiatric Association
Clinically defined vascular depression
GS Alexopoulos, BS Meyers, RC Young, T Kakuma, D Silbersweig and M Charlson
Cornell University Medical College, New York, USA.
OBJECTIVE: The authors' goal was to examine the clinical presentation of a
group of depressed elderly patients with clinically defined risk factors
for vascular depression compared with a group of elderly depressed patients
without such risk factors. METHOD: Cognitive deficits, disability, and
depressive symptoms were examined in 33 consecutively recruited elderly
patients defined as having vascular depression and 32 patients defined as
having nonvascular depression according to their scores on the Cumulative
Illness Rating Scale- Geriatrics. RESULTS: The patients with vascular
depression had greater overall cognitive impairment and disability than
those with nonvascular depression. Fluency and naming were more impaired in
patients with vascular depression, and they had more retardation and less
agitation as well as less guilt feelings and greater lack of insight.
CONCLUSIONS: The symptoms of vascular depression are consistent with
lesions that may damage striato-pallido-thalamo-cortical pathways and other
areas. The concept of vascular depression can provide the impetus for
investigations of prevention and treatment of cerebrovascular disease and
for studies of the course of vascular depression and selection of
antidepressants.
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J. M. Lyness, E. D. Caine, C. Cox, D. A. King, Y. Conwell, and T. Olivares
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