González Torrecillas J I, Mendlewicz J, Lobo A
Servicio de Psiquiatría, Hospital Erasme, Universidad Libre de Bruselas, Bélgica.
Med Clin (Barc). 1997 Sep 6;109(7):241-4.
Several studies have suggested a close relationship between intensity of poststroke depression and lesion location, but the relationships are not clear for some authors. In this study we try to test the hypothesis that the intensity of depression in an early stage (4th week) of cerebral vascular accidents (CVA) in related to lesion location and type of lesion.
In a sample of one hundred and thirty patients in the fourth week of the evolution of an unilateral CVA, 48 patients fulfilled research diagnostic criteria (RDC) of post-stroke depression (34 major depression; 14 minor depression). Schedule for Affective Disorders and Schizophrenia (SADS) and standard measures of intensity of depression (Hamilton's HRDS, Montgomery-Asberg's MADRS and Beck's BDI) were used.
In the fourth week of the evolution of CVA's, depression intensity measures (HRDS and BDI) were significantly higher in anterior lesion when compared to posterior lesions. No significant differences were found between right and left lesions, but both were higher than in non-hemispheric lesions. No significant differences of prevalence or intensity of depression were found in relation to lesion type (hemorrhagic/ischaemic).
The results confirm a relationship between intensity mood disorders after a cerebral vascular accident and the topography of the lesion.
多项研究表明，中风后抑郁的严重程度与病变部位密切相关，但部分作者认为两者关系尚不明确。在本研究中，我们试图验证以下假设：脑血管意外（CVA）早期（第4周）的抑郁严重程度与病变部位及病变类型有关。
选取130名单侧CVA病程第4周的患者作为样本，其中48例符合中风后抑郁的研究诊断标准（RDC）（34例为重度抑郁；14例为轻度抑郁）。采用情感障碍与精神分裂症日程表（SADS）以及抑郁严重程度的标准测量方法（汉密尔顿抑郁量表HRDS、蒙哥马利-阿斯伯格抑郁量表MADRS和贝克抑郁量表BDI）。
在CVA病程第4周时，与后部病变相比，前部病变的抑郁严重程度测量值（HRDS和BDI）显著更高。左右病变之间未发现显著差异，但两者均高于非半球性病变。在抑郁患病率或严重程度方面，未发现与病变类型（出血性/缺血性）有关的显著差异。
结果证实了脑血管意外后情绪障碍严重程度与病变部位之间的关系。
