Reifler B V, Larson E, Teri L, Poulsen M
J Am Geriatr Soc. 1986 Dec;34(12):855-9. doi: 10.1111/j.1532-5415.1986.tb07258.x.
This retrospective review of medical records was designed to address three questions: 1) Can the depression seen in some patients with Dementia of the Alzheimer's Type (DAT) be successfully treated? 2) Does this treatment lead to any long-term improvement in the patient's cognitive status? and 3) Do patients with coexisting DAT and depression have a different long-term clinical course than nondepressed DAT patients? In the authors' sample of 131 DAT subjects, 41 (31%) also met DMS-III criteria for a major affective disorder. Of those DAT plus depression patients whose records reflected treatment (usually with a tricyclic antidepressant), 85% (17 of 20) showed clear evidence of improvement in mood, vegetative signs, or activities of daily living (ADLs) based on review of the medical record. An analysis of change in cognitive function (measured by the Folstein Mini-Mental State) and five global measures failed to reveal any differences between the depressed and nondepressed groups after a mean interval of 17 months. The depression that occurs in approximately one-quarter to one-third of DAT patients appears to respond to appropriate therapy. These patients often show improvement in their mood and ADLs but remain demented.
1）阿尔茨海默病型痴呆（DAT）患者中出现的抑郁能否得到成功治疗？2）这种治疗能否使患者的认知状态得到长期改善？3）同时患有DAT和抑郁症的患者与未患抑郁症的DAT患者相比，长期临床病程是否不同？在作者选取的131名DAT受试者样本中，41名（31%）也符合《精神疾病诊断与统计手册》第三版（DMS - III）中重度情感障碍的标准。在那些有治疗记录（通常使用三环类抗抑郁药）的DAT合并抑郁症患者中，根据病历回顾，85%（20例中的17例）在情绪、躯体症状或日常生活活动（ADL）方面有明显改善迹象。对认知功能变化（通过福尔斯坦简易精神状态检查表测量）和五项综合指标进行分析后发现，在平均间隔17个月后，抑郁组和非抑郁组之间没有任何差异。约四分之一至三分之一的DAT患者出现的抑郁似乎对适当治疗有反应。这些患者的情绪和ADL通常会有所改善，但仍患有痴呆症。
