Azorin J M, Donnet A, Habib M, Regis H
Clinique de Psychiatrie, CHU Timone, Marseille.
Encephale. 1990 Jan-Feb;16(1):31-4.
Ten patients fulfilling the DSM III (A, B, C, D) criteria for both dementia and major depression and presenting the diagnostic dilemma of depressive pseudodementia were included in a prospective study in search of indices for the differential diagnosis of depressive pseudodementia (DPSD) and organic dementia (OD). Patients were assessed with the Hamilton Depression Rating Scale (HDRS), the Blessed Dementia Rating Scale (BDRS), the Wells's criteria, the Mini Mental State (MMS), computerized tomography (CT scan) of the brain, the dexamethasone suppression test (DST), total plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) and sleep electroencephalograms (EEG). Patients suffering from DPSD were defined as showing an improvement higher than 50% in both the HDRS et BDRS scores following adequate antidepressant treatment. Wells's criteria, MMS scores, CT scan and DST do not contribute to the separation of DPSD (n = 6) and OD (n = 4). On the contrary, plasma MHPG levels higher than 35 ng/ml and EEG measures of sleep structure and REM sleep significantly differentiate the two groups.
十名符合痴呆症和重度抑郁症的DSM III（A、B、C、D）标准且存在抑郁性假性痴呆诊断困境的患者被纳入一项前瞻性研究，以寻找区分抑郁性假性痴呆（DPSD）和器质性痴呆（OD）的指标。患者接受了汉密尔顿抑郁量表（HDRS）、Blessed痴呆评定量表（BDRS）、韦尔斯标准、简易精神状态检查表（MMS）、脑部计算机断层扫描（CT扫描）、地塞米松抑制试验（DST）、血浆总3-甲氧基-4-羟基苯乙二醇（MHPG）和睡眠脑电图（EEG）评估。患有DPSD的患者被定义为在接受充分的抗抑郁治疗后，HDRS和BDRS评分均有超过50%的改善。韦尔斯标准、MMS评分、CT扫描和DST无助于区分DPSD（n = 6）和OD（n = 4）。相反，血浆MHPG水平高于35 ng/ml以及睡眠结构和快速眼动睡眠的脑电图测量结果能显著区分这两组。
