Fujikawa T, Yamawaki S, Touhouda Y
Department of Neurology and Psychiatry, Hiroshima University School of Medicine, Japan.
Stroke. 1993 Nov;24(11):1631-4. doi: 10.1161/01.str.24.11.1631.
There have been few studies of the incidence of silent cerebral infarction detected by magnetic resonance imaging in patients with presenile or senile major depression.
We examined silent cerebral infarction in patients with presenile and senile major depression who were diagnosed at Hiroshima Prefectural Hospital. The diagnostic criteria of the American Psychiatric Association (DSM-III-R) were used. Patients with stroke or focal neurological symptoms were excluded.
Silent cerebral infarction was observed in 51.4% of the patients with presenile-onset presenile depression, and the incidence was significantly higher than in patients with juvenile-onset presenile depression (P < .01). Among the patients with senile major depression, silent cerebral infarction was observed in 65.9% of those with presenile-onset depression and in 93.7% of those with senile-onset depression.
Our findings suggest that half of presenile-onset major depression and the majority of senile-onset major depression might be organic depression related to silent cerebral infarction. Because major depression occurring for the first time during or after the presenile period may be related to silent cerebral infarction, it is important to keep this possibility in mind when treating such patients.
关于磁共振成像检测到的老年前期或老年期重度抑郁症患者无症状性脑梗死发生率的研究较少。
我们对广岛县立医院诊断的老年前期和老年期重度抑郁症患者进行了无症状性脑梗死检查。采用美国精神病学协会（DSM-III-R）的诊断标准。排除患有中风或局灶性神经症状的患者。
老年前期起病的老年前期抑郁症患者中，51.4%观察到无症状性脑梗死，其发生率显著高于少年期起病的老年前期抑郁症患者（P <.01）。在老年期重度抑郁症患者中，老年前期起病的抑郁症患者中有65.9%观察到无症状性脑梗死，老年期起病的抑郁症患者中有93.7%观察到无症状性脑梗死。
我们的研究结果表明，半数老年前期起病的重度抑郁症和大多数老年期起病的重度抑郁症可能是与无症状性脑梗死相关的器质性抑郁症。由于在老年前期期间或之后首次发生的重度抑郁症可能与无症状性脑梗死有关，在治疗此类患者时牢记这种可能性很重要。
