Ramasubbu R, Kennedy S H
Department of Psychiatry, Toronto Hospital, Ontario.
Can J Psychiatry. 1994 Dec;39(10):601-7. doi: 10.1177/070674379403901004.
Neurological deficits associated with cerebrovascular disease such as aphasia, dementia, anosognosia and aprosodia may impair the ability to express or experience depressive symptoms. Identification of depression in the absence of verbal report on subjective mood state is a difficult task. The value of various diagnostic methods including depressive rating scales, standard psychiatric interviews and biological variables in the diagnosis of depression in cerebrovascular disease is considered. This review concludes by focusing on the deficiencies of existing approaches in the diagnostic assessment of depression in patients with severe communication and comprehension deficits and emphasizes the importance of devising a standard diagnostic method with less reliance on verbal responses.
与脑血管疾病相关的神经功能缺损，如失语症、痴呆、疾病感缺失和韵律障碍，可能会损害表达或体验抑郁症状的能力。在缺乏关于主观情绪状态的言语报告的情况下识别抑郁症是一项艰巨的任务。本文探讨了包括抑郁评定量表、标准精神科访谈和生物学变量在内的各种诊断方法在脑血管疾病抑郁症诊断中的价值。本综述最后着重指出了现有方法在严重沟通和理解障碍患者抑郁症诊断评估中的不足，并强调了设计一种较少依赖言语反应的标准诊断方法的重要性。
