Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Depression as a mask for dyscirculatory encephalopathy and its therapy

Full Text:


In outpatient practice, neurologists often face patients diagnosed with dyscirculatory encephalopathy (DEP). Sleep disorders, headaches, rapid and unexplained fatigability, and irritability are predominating, which poses a number of complex medical issues. A case report of a 69 year-old patient, who was being followed up for a long time because of DEP diagnosis is reported. However, examination of the neu-ropsychic status revealed the depressive disorder with somatoform complaints, which was verified by a psychiatrist. Psychotherapy and antidepressant therapy led to significant improvement.
The differential diagnosis and treatment of depressive disorders in outpatient practice are discussed. 

About the Authors

D.V. Neverovskiy
City Clinic No 44, St. Petersburg, Russia
Russian Federation

S.F. Sluchevskaya
I.I. Mechnikov Northwestern State Medical University, Ministry of Health of the Russian Federation, St. Petersburg, Russia


1. Парфенов ВА. Постинсультная депрессия: распространенность, патогенез, диагностика и лечение. Неврология, нейропсихиатрия, психосоматика. 2012;(4):84–8. [Parfenov VA. Poststroke depression: prevalence, pathogenesis, diagnosis, and treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(4):84–8. (In Russ.)]. DOI:

2. Post F. The significance of Affective symptoms in Old Age. A Follow-up of One Hundred Patients. London: Oxford University Press; 1962.

3. Яхно НН, Захаров ВВ. Когнитивные и эмоционально-аффективные нарушения при дисциркуляторной энцефалопатии. Русский медицинский журнал. 2002;10(12–13):532–42. [Yakhno NN, Zakharov VV. Cognitive and emotional and affective violations at distsirkulyatorny encephalopathy. Russkii meditsinskii zhurnal. 2002;10(12–13):532–42. (In Russ.)]

4. Парфенов ВА. Дисциркуляторная энцефалопатия: дифференциальный диагноз и лечение. Клиницист. 2008;1(1):38–44. [Parfenov VA. Dyscirculatory encephalopathy: differential diagnosis and treatment. Klinitsist. 2008;1(1):38–44. (In Russ.)]

5. O'Brien J, Ames D, Gustafson L, et al., editors. Cerebrovascular disease, cognitive imairment and dementia. 2nd ed. Cerebrovascular disease and dementia London: Martin-Dunitz; 2004. P. 260–2.

6. Холмогорова АБ. Интегративная психотерапия расстройств аффективного спектра. Москва: Медпрактика; 2011. 480 с. [Kholmogorova AB. Integrativnaya psikhoterapiya rasstroistv affektivnogo spectra

7. [Integrative psychotherapy of frustration of an affective range]. Moscow: Medpraktika; 2011. 480 p.]

8. Холмогорова АБ, Гаранян НГ, Петрова ГА. Социальная поддержка как предмет научного изучения и ее нарушения у больных с расстройствами аффективного спектра. Социальная и клиническая психиатрия. 2003;13(2):15–23. [Kholmogorova AB, Garanyan NG, Petrova GA. Social support as a subject of scientific studying and its violation at patients with frustration of an affective range. Sotsial'naya i klinicheskaya psikhiatriya. 2003;13(2):15–23. (In Russ.)]

9. Дамулин ИВ, Парфенов ВА, Скоромец АА и др. Нарушения кровообращения в головном и спинном мозге. В кн.: Болезни нервной системы. Под ред. Яхно НН. Т. 1. Москва: Медицина; 2005. С. 274–84. [Damulin IV, Parfenov VA, Skoromets AA, et al. Narusheniya krovoobrashcheniya v golovnom i spinnom mozge. V kn.: Bolezni nervnoi sistemy. [Blood circulation violations in a head and spinal cord. In: Diseases of nervous system.]. Yakhno NN, editor. Moscow: Meditsina; 2005. Vol. 1. P. 274–84.]

10. Coulston T. Clinical Lectires on Mental Diseases, 6th edition. London: J&A Churchill; 1904. P. 628–55.

11. Lyketsos C, Lopez O, Jones B, et al. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment. JAMA. 2002;288(12):1475–83. DOI:

12. Ballard C, O’Brien J. Behavioural and psychological symptoms. In: Erkinjuntti T, Gauthier S, edtitors. Vascular cognitive impairment London: Martin-Dunitz; 2002. P. 237–52.

13. Rao R. Cerebrovascular disease and late life depression: an age old association revisited. Int J Geriat Psychiatry. 2000;15(5):419–33. DOI:;2-9.

14. Beltman MW, Voshaar RC, Speckens AE. Cognitive-behavioural therapy for depression in

15. people with a somatic disease: meta-analysis of randomised controlled trials. Br J Psychiatry. 2010;197(1):11–9. DOI:

16. Wilson K, Mottram P, Sivanranthan A, Nightingale A. Antidepressants versus placebo for the depressed elderly (Cochrane Review). In: The Cochrane Library. Chichester, UK: John Wiley & Sons, Ltd; 2003;4.

17. Friedman RA, Leon AC. Expanding the black box - depression, antidepressants, and the risk of suicide. N Engl J Med. 2007;356(23):2343–6. DOI:

18. Kendler KS, Aggen SH, Knudsen GP, et al. The structure of genetic and environmental risk factors for syndromal and subsyndromal common DSM-IV axis I and all axis II disorders. Am J Psychiatry. 2011;168(1):29–39. DOI: 2010.10030340.

19. Trivedi MH, Fava M, Wisniewski SR, et al. Medication augmentation after the failure of SSRIs for depression. N Engl J Med. 2006;354(12):1243–52. DOI:

20. Cipriani A, Koesters M, Furukawa TA, et al. Duloxetine versus other anti-depressive agents for depression. Cochrane Database Syst Rev. 2012 Oct 17;10:CD006533. DOI: 10.1002/14651858.CD006533.pub2.

21. Cubala WJ, Landowski J. Prolactin response to buspirone is not impaired in drug-naive first episode patients with major depressive disorder. J Affect Disord. 2013;152–154:468–73. DOI: 10.1016/j.jad.2013.08.005. Epub 2013 Aug 22.

22. Jacob S, Spinler SA. Hyponatremia associated with selective serotonin-reuptake inhibitors in older adults. Ann Pharmacother. 2006;40(9):1618–22. DOI: Epub 2006 Aug 8.


For citations:

Neverovskiy D., Sluchevskaya S. Depression as a mask for dyscirculatory encephalopathy and its therapy. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(1):44-47. (In Russ.)

Views: 1429

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

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