Rickards Hugh
Department of Neuropsychiatry, Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham, UK.
Curr Opin Psychiatry. 2006 May;19(3):294-8. doi: 10.1097/01.yco.0000218601.17722.5b.
Depressions are a heterogeneous group of conditions that contribute significantly to impairments in quality of life, independent of the severity of neurological illness. Depression may predate neurological signs and symptoms in the evolution of neurodegenerative disorders, and there is some evidence that depressive illness itself may be a risk factor in the aetiology of some dementias. This review aims to summarize the relevant current literature on diagnosis, aetiology and treatment of depression in neurology.
Diagnosing depression in neurological conditions can be particularly difficult because of communication difficulties and changes in emotional expression as a result of the underlying neurological disease. Rating scales loaded towards somatic symptoms can show poor validity for screening or rating of severity in this setting. The evidence for the treatment of depression in neurological disease is scant, and often the treatment advice is based on consensus views of clinicians. Nevertheless, there have been some clinical trials, which are reported.
Depression is common in neurology. It is underrecognized and undertreated. Recent research has allowed us to define depression more clearly in this setting. Trials of treatment are urgently needed, especially as depression is a significant factor in quality of life and may affect prognosis.
抑郁症是一组异质性疾病，严重影响生活质量，与神经疾病的严重程度无关。在神经退行性疾病的发展过程中，抑郁可能先于神经体征和症状出现，并且有证据表明，抑郁症本身可能是某些痴呆症病因中的一个危险因素。本综述旨在总结当前有关神经病学中抑郁症诊断、病因和治疗的相关文献。
由于潜在神经疾病导致的沟通困难和情绪表达变化，在神经疾病中诊断抑郁症可能特别困难。在这种情况下，侧重于躯体症状的评定量表在筛查或评定严重程度方面可能效度不佳。神经疾病中抑郁症治疗的证据很少，治疗建议通常基于临床医生的共识意见。尽管如此，仍有一些已报道的临床试验。
抑郁症在神经病学中很常见。它未得到充分认识和治疗。最近的研究使我们能够在这种情况下更清楚地定义抑郁症。迫切需要进行治疗试验，尤其是因为抑郁症是生活质量的一个重要因素，并且可能影响预后。
