Iosifescu Dan V, Renshaw Perry F, Dougherty Darin D, Lyoo In Kyoon, Lee Ho Kyu, Fraguas Renerio, Cassano Paolo, Nierenberg Andrew A, Fava Maurizio
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
J Nerv Ment Dis. 2007 Feb;195(2):175-8. doi: 10.1097/01.nmd.0000253820.69362.87.
Previous reports of increased rates of cardiovascular risk factors in major depressive disorder (MDD) with anger attacks led the authors to hypothesize that MDD with anger attacks may be associated with brain vascular changes (magnetic resonance imaging white matter hyperintensities [WMHs]). Sixty-five subjects meeting DSM-III-R criteria for major depressive disorder were administered brain magnetic resonance imaging scans at 1.5T to detect T2 WMH. The severity of brain WMH was classified with the Fazekas scale. We used standardized scales to assess melancholic MDD, atypical MDD, and MDD with anger attacks. In logistic regression analyses, MDD with anger attacks was associated with higher severity of subcortical WMH and of total WMH, but not with periventricular WMH. Atypical and melancholic MDD subtypes were not significantly associated with brain WMH. In conclusion, subcortical brain vascular lesions may be more prevalent or severe in MDD with anger attacks.
先前关于伴有愤怒发作的重度抑郁症（MDD）中心血管危险因素发生率增加的报告，促使作者推测伴有愤怒发作的MDD可能与脑血管变化（磁共振成像白质高信号[WMHs]）有关。65名符合DSM-III-R重度抑郁症标准的受试者接受了1.5T的脑部磁共振成像扫描，以检测T2 WMH。脑WMH的严重程度采用Fazekas量表进行分类。我们使用标准化量表评估抑郁性MDD、非典型MDD和伴有愤怒发作的MDD。在逻辑回归分析中，伴有愤怒发作的MDD与皮质下WMH和总WMH的更高严重程度相关，但与脑室周围WMH无关。非典型和抑郁性MDD亚型与脑WMH无显著关联。总之，伴有愤怒发作的MDD中皮质下脑血管病变可能更普遍或更严重。
