Gilles C
Service de Psychiatrie, Hôpital Ambroise Paré, Mons.
Rev Med Brux. 1994 Sep-Oct;15(5):296-9.
Dementia and depression are among the most frequent and disabling conditions in the elderly. The prognosis of depression is similar in young and elderly patients; however, treatment can be more risky in the latter. Incorrect diagnosis of dementia as well as therapeutic relentlessness should be avoided. An attempt is made to clarify the ways dementia and depression can combine. The reality of pure depressive pseudodementia seems doubtful. Depression can worsen a dementia. Cognitive dysfunction can be observed in depression, though it is difficult to estimate the extent and the meaning of this association. Patients with very mild dementia are often referred for a depression, which is ruled out by careful examination. There is no simple mean to differentiate dementia from depression. The proper way remains to perform a strict clinical, neuropsychological and psychiatric examination.
痴呆和抑郁症是老年人中最常见且导致残疾的病症。年轻患者和老年患者抑郁症的预后相似;然而,老年患者的治疗风险可能更高。应避免将痴呆误诊以及治疗不力的情况。本文试图阐明痴呆和抑郁症可能合并的方式。纯粹的抑郁性假性痴呆的实际情况似乎存疑。抑郁症会使痴呆病情恶化。抑郁症中可观察到认知功能障碍,不过难以评估这种关联的程度和意义。患有非常轻度痴呆的患者常因疑似抑郁症前来就诊,通过仔细检查可排除抑郁症。没有简单的方法来区分痴呆和抑郁症。正确的方法仍然是进行严格的临床、神经心理学和精神科检查。