Mast Benjamin T, MacNeill Susan E, Lichtenberg Peter A
Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA.
Am J Geriatr Psychiatry. 2004 Jan-Feb;12(1):84-92.
The authors examined the vascular depression hypothesis by comparing the frequency of post-stroke depression and clinically-defined vascular depression and by examining the relationship between vascular burden and depression.
Data from 670 geriatric rehabilitation patients were incorporated to compare the frequency of depression in three patient groups: 1) those with no evidence of vascular disease or stroke, 2) those with cerebrovascular risk factors (CVRFs) but no evidence of stroke, and 3) patients with stroke. They examined the unique relationship between CVRFs and depression by use of logistic-regression analysis.
Although the frequency of depression was not significantly different between stroke (36.4%), CVRF (35.2%), and non-vascular patients (28.7%), there was a significant increase in the frequency of depression in patients without stroke as CVRF burden increased. This effect was not observed among stroke patients. CVRF burden predicted depression among patients without stroke even after controlling for general medical comorbidity, cognitive functioning, and ADL limitations.
These findings provide empirical support for the vascular depression hypothesis and also indicate that the rates of clinically-defined vascular depression and post-stroke depression are similar in geriatric rehabilitation patients.
作者通过比较中风后抑郁和临床定义的血管性抑郁的发生率，并研究血管负担与抑郁之间的关系，来检验血管性抑郁假说。
纳入670名老年康复患者的数据，以比较三组患者的抑郁发生率：1）无血管疾病或中风证据的患者；2）有脑血管危险因素（CVRF）但无中风证据的患者；3）中风患者。他们通过逻辑回归分析研究了CVRF与抑郁之间的独特关系。
尽管中风患者（36.4%）、CVRF患者（35.2%）和非血管疾病患者（28.7%）的抑郁发生率无显著差异，但随着CVRF负担增加，无中风患者的抑郁发生率显著上升。在中风患者中未观察到这种效应。即使在控制了一般医疗合并症、认知功能和日常生活活动能力受限等因素后，CVRF负担仍可预测无中风患者的抑郁情况。
这些发现为血管性抑郁假说提供了实证支持，同时也表明在老年康复患者中，临床定义的血管性抑郁和中风后抑郁的发生率相似。
