Chiu Pai-Yi, Wang Chein-Wei, Tsai Chun-Tang, Li Shin-Hua, Lin Chih-Li, Lai Te-Jen
Department of Neurology, Show Chwan Memorial Hospital, Changhua, Taiwan.
Department of Neurology, Taichung Lin-Shin Hospital, Taichung, Taiwan.
PLoS One. 2017 Jun 15;12(6):e0179399. doi: 10.1371/journal.pone.0179399. eCollection 2017.
Depression is highly associated with dementia, and this study will compare the frequencies, severity, and symptoms of depression between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD).
Frequency of depression was determined according to the DSM-IV criteria for major depression or the National Institute of Mental Health criteria for depression in AD (NIMH-dAD). Severity of depression were assessed using the Hamilton Depression Rating Scale, the Cornell Scale for Depression in Dementia, and the depression subscale in Neuropsychiatric Inventory. The rates of depressive symptoms were compared between AD and DLB.
A total of 312 patients were investigated (AD/DLB = 241/71). The frequency of major depression was significantly higher (p = 0.017) in DLB (19.7%) than in AD (8.7%). The higher frequency of depression in DLB was not reproduced by using the NIMH-dAD criteria (DLB: AD = 43.7%: 33.2%; p = 0.105). The severity of depression was higher in DLB than in AD according to the Hamilton Depression Rating Scale (p < 0.001) and the Cornell Scale for Depression in Dementia (p < 0.001). Among depressive symptoms, pervasive anhedonia had the highest odds ratio in DLB compared with AD.
This is the first study using the NIMH-dAD criteria to investigate the frequency of depression in DLB. Our study shows that co-morbid major depression is more frequent in DLB than in AD. Pervasive anhedonia had the greatest value for the differential diagnosis of depression between DLB and AD.
抑郁症与痴呆症高度相关，本研究将比较路易体痴呆（DLB）和阿尔茨海默病（AD）患者抑郁症的发生率、严重程度及症状。
根据《精神疾病诊断与统计手册》第四版中重度抑郁症的标准或美国国立精神卫生研究所的AD抑郁症标准（NIMH-dAD）来确定抑郁症的发生率。使用汉密尔顿抑郁量表、康奈尔痴呆抑郁量表以及神经精神科问卷中的抑郁分量表来评估抑郁症的严重程度。比较AD和DLB患者的抑郁症状发生率。
共调查了312例患者（AD/DLB = 241/71）。DLB患者中重度抑郁症的发生率（19.7%）显著高于AD患者（8.7%）（p = 0.017）。使用NIMH-dAD标准时，DLB患者较高的抑郁症发生率未得到重现（DLB：AD = 43.7%：33.2%；p = 0.105）。根据汉密尔顿抑郁量表（p < 0.001）和康奈尔痴呆抑郁量表（p < 0.001），DLB患者的抑郁严重程度高于AD患者。在抑郁症状中，与AD相比，弥漫性快感缺失在DLB患者中的比值比最高。
这是第一项使用NIMH-dAD标准调查DLB患者抑郁症发生率的研究。我们的研究表明，DLB患者中合并重度抑郁症的情况比AD患者更常见。弥漫性快感缺失对DLB和AD患者抑郁症的鉴别诊断具有最大价值。
