Reichman W E, Coyne A C
COPSA Institute for Alzheimer's Disease and Related Disorders, UMDNJ, CMHC, Piscataway 08855-1392, USA.
J Geriatr Psychiatry Neurol. 1995 Apr;8(2):96-9. doi: 10.1177/089198879500800203.
We examined the prevalence of major depression, depressed mood/anhedonia, and subjective and neurovegetative symptoms of depression that were unaccompanied by depressed mood/anhedonia in patients with clinically-diagnosed Alzheimer's disease (AD) and multi-infarct dementia (MID). The specificity of subjective and neurovegetative depressive symptoms for depressed mood in dementia was examined, as was the impact on depression of clinical variables such as family history, patient age, and dementia severity. Subjects were 105 outpatients who met DSM-III-R criteria for AD (n = 67) or MID (n = 38). Depressed mood/anhedonia was frequently noted in both the AD (40.3%) and MID (34.2%) groups. One or more depressive symptoms, not accompanied by depressed mood/anhedonia, were also common in AD and MID (49.3% and 36.8%, respectively). Major depression was relatively uncommon in AD (10.5%) but was noted more frequently in MID (29.0%). Among AD patients, neurovegetative symptoms of depression were not any more common in patients with depressed mood/anhedonia than in those without depressed mood/anhedonia. Subjective symptoms of depression were also not significantly associated with depressed mood/anhedonia. The study highlights the importance of viewing major depression, depressed mood-anhedonia, and other depressive symptoms (subjective and neurovegetative) as separate entities in AD and MID.
我们调查了临床诊断为阿尔茨海默病（AD）和多发梗死性痴呆（MID）的患者中重度抑郁症、情绪低落/快感缺失以及无情绪低落/快感缺失伴随的抑郁症主观及神经植物性症状的患病率。研究了痴呆患者中主观及神经植物性抑郁症状对于情绪低落的特异性，以及家族史、患者年龄和痴呆严重程度等临床变量对抑郁症的影响。研究对象为105名符合AD（n = 67）或MID（n = 38）的DSM-III-R标准的门诊患者。AD组（40.3%）和MID组（34.2%）中经常出现情绪低落/快感缺失。AD和MID患者中，一种或多种无情绪低落/快感缺失伴随的抑郁症状也很常见（分别为49.3%和36.8%）。重度抑郁症在AD中相对少见（10.5%），但在MID中更常见（29.0%）。在AD患者中，有情绪低落/快感缺失的患者的抑郁神经植物性症状并不比无情绪低落/快感缺失的患者更常见。抑郁主观症状也与情绪低落/快感缺失无显著关联。该研究强调了将重度抑郁症、情绪低落-快感缺失及其他抑郁症状（主观和神经植物性）视为AD和MID中不同实体的重要性。
