Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Analysis of affective disorders in patients with vascular dementia

https://doi.org/10.14412/2074-2711-2012-2511

Full Text:

Abstract

The outpatient records of 147 patients followed up for diagnosed vascular dementia were analyzed to assess the relationship between affective disorders and severe cognitive impairments. It was found that 7% of the examinees had a history of depressive states. Estimating the development time for vascular dementia could divide the patients into 2 groups: 1) 60% of the patients in whom cognitive impairments began to determine its clinical picture just within the first 2 years after identification of affective disorders and 2) 40%, in whom cognitive impairments occurred 10—20 years later. In both groups, mental disorders occurred at an equal age in the presence of depressive disorders; in Group 1, vascular dementia developed nearly twice as often as that in Group 2. At the same time, the occurrence of cognitive impairments in Group 1 patients just in the early disease stages is indicative of the organic genesis of affective disorders, as confirmed by the moderately rapid progression of psychopathological symptoms, such as sharpening of personality traits, increased rigidity of psychic processes, emotional lability, variations in affective symptomatology, inadequate remissions, and the presence of neurological symptoms. Another type of a ratio of depressive to severe cognitive disorders was found in the elderly persons in Group 2. The long existence of affective disorders without signs of cognitive diminution leads one to say that they have recurrent depressive disorder with further addition of a comorbid vascular process. These patients showed a fairly high severity of affective pathology that was responsible for more frequent admissions, as well as a phase course with relatively pure remissions without any clear intellectual-mnestic reduction and a predominance of hysterical character traits.

About the Authors

D. V. Zakharchenko
V.M. Bekhterev Psychoneurology Research Institute, Saint Petersburg
Russian Federation


N. G. Neznanov
V.M. Bekhterev Psychoneurology Research Institute, Saint Petersburg
Russian Federation


N. M. Zalutskaya
V.M. Bekhterev Psychoneurology Research Institute, Saint Petersburg
Russian Federation


References

1. <div><p>Медведев А.В. Сосудистая деменция. Совр психиатр 1998;4:20–3.</p><p>Sapolsky R.M. Stress, the Aging Brain, and the Mechanisms of Neuron Death. Cambridge: MIT Press, 1992.</p><p>Keller M.B., Lavori P.W., Rice J. et al. The persistent risk of chronicity in recurrent episodes of nonbipolar major depressive disorder: a prospective follow-up. Am J Psychiatry 1986;143:24–8.</p><p>Alexopoulos G.S., Meyers B.S., Young R.C. The course of geriatric depression with ”reversible dementia”: a controlled study. Am J Psychiatry 1993;150:1693–9.</p><p>Alexopoulos G.S., Young R.C., Meyers B.S. Geriatric depression: age of onset and dementia. Biol Psychiatry 1993;34:141–5.</p><p>Jacoby R.J., Levy R. Computed tomography in the elderly. 3. Affective disorder. Br J Psychiatry 1980;136:270–5.</p><p>Alexopoulos G.S., Vrontou C., Kakuma T. Disability in geriatric depression. Am J Psychiatry 1996;153:877–85.</p><p>Jacoby R.J., Levy R., Bird J.M. Computed tomography and the outcome of affective disorder: a follow-up study of elderly patients. Br J Psychiatry 1981;139:288–92.</p><p>Roth M., Kay D.W. Affective disorders arising in the senium. II. Physical disability as an aetiological factor. J Ment Sci 1956;102:141–50.</p><p>Musselman D.L, Evans D.L, Nemeroff C.B. The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch Gen Psychiatry 1998;55:580–92.</p><p>Moussavi S., Chatterji S., Verdes E. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370:851–8.</p><p>Braak H., Braak E. Frequency of stages of Alzheimer–related lesions in different age categories. Neurobiolog Aging 1997;18:351–7.</p><p>Alexopoulos G.S., Meyers B.S., Young R.S. et al. Vascular depression hypothesis. Arch Gen Psychiatr 1997;54:915–22.</p><p>Путилина М.В. Хроническая ишемия мозга. Леч врач 2005;6:28–33.</p><p>Post F. The significance of affective disorders in old age. London: Institute of Psychiatry, 1962.</p><p>Post F., Schulman K. New views on old age affective disorder. In: Aire T, editor. Recent advances in psychogeriatrics. New York: Churchill Livingstone, 1985;119–40.</p><p>O'Brien H.J.T., Ames D., Schweitzer I. White matter changes in depression and Alzheimer's disease: a review of magnetic resonance imaging studies. Int J Geriatr Psychiatry 1996;11:681–94.</p><p>Matsuo K., Onodera Y., Hamamoto T. et al. Hypofrontality and microvascular dysregulation in remitted late–onset depression assessed by functional near–infrared spectroscopy. Neuroimage 2005;26(1):234–42.</p><p>Григорьева Е.А., Дьяконов А.Л., Яльцева Н.В. и др. Особенности депрессивных расстройств у больных ишемической болезнью сердца и влияние коаксила на их течение. Психические расстройства в общей медицине 2006;2:23–7.</p><p>Reiss E. Z Ges Neurol Psychiat 1910;11:348–628.</p><p>Raecke J. Arch Psychiat Nervenkr 1905;40:171–211.</p><p>Krauz A. Hysteric heute, Metamorphosen eines Paradiesvogels. Stuttgart: Enke-Verlag, 1996.</p><p>Дубенко А.Е., Коростий В.И., Якущенко И.А. Когнитивные нарушения и депрессия у больных пожилого возраста – дифференциальная диагностика и коморбидность. Здоровье Украины 2008;12(1):30–3.</p><p>Hebert R., Lindsay J., Verreault R. et al. Vascular dementia. incidence and risk factors in the Canadian Study of Health and Aging. Stroke 2000;31:1487–93.</p><p>Sheline Y.I., Mittler B.L., Mintun M.A. The hippocampus and depression. Eur Psychiatry 2002;17(Suppl 3):300–5.</p><p>Арушанян Э.Б., Бейер Э.В. Гиппокамп и нарушения познавательной деятельности. Журн неврол и психиатр 2007;107(7):72–7.</p><p>Коломеец Н.С. Патология гиппокампа при шизофрении. Журн неврол и психиатр 2007;107(12):103–14.</p><p>Shimbo D., Davidson K.W., Haas D.C. et al. Negative impact of depression on outcomes in patients with coronary artery disease: mechanisms, treatment considerations, and future directions. J Thromb Haemost 2005;3(5):897–908.</p><p>Jorm A.F. History of depression as a risk factor for dementia: an updated review. Aust N Z J Psychiatry 2001;35(6):776–81.</p></div><br />


Review

For citations:


Zakharchenko D.V., Neznanov N.G., Zalutskaya N.M. Analysis of affective disorders in patients with vascular dementia. Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2S):61-64. (In Russ.) https://doi.org/10.14412/2074-2711-2012-2511

Views: 757


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)