Lyness J M, Caine E D, Cox C, King D A, Conwell Y, Olivares T
Department of Psychiatry, University of Rochester School of Medicine and Dentistry, New York, USA.
Am J Geriatr Psychiatry. 1998 Winter;6(1):5-13.
The topic of vascular depression has received increasing prominence as a putative etiology of depression in later life. The authors examined one aspect of this model by comparing the burden of systemic cerebrovascular risk factors (CVRFs) in 130 psychiatric inpatients with major depression and 64 normal control (NC) subjects, all age > or = 50 years. Depressed subjects did not differ statistically from NCs on cumulative CVRF scores. Diabetes mellitus and atrial fibrillation were both associated with depression, but only atrial fibrillation retained an independent association after medical disability was statistically controlled. Among the depressed subjects, CVRF scores were not significantly associated with overall symptom severity, psychiatric disability, age at onset of depression, melancholic subtype, or psychotic depression. These data did not support the notion that a linear model of small-vessel disease might apply to the great majority of older inpatients with major depression.
血管性抑郁这一话题作为晚年抑郁症的一种假定病因，已受到越来越多的关注。作者通过比较130名患有重度抑郁症的精神科住院患者和64名正常对照（NC）受试者（年龄均≥50岁）的全身性脑血管危险因素（CVRF）负担，对该模型的一个方面进行了研究。抑郁症患者在累积CVRF评分上与正常对照组无统计学差异。糖尿病和心房颤动均与抑郁症相关，但在对医疗残疾进行统计学控制后，只有心房颤动仍保持独立关联。在抑郁症患者中，CVRF评分与总体症状严重程度、精神残疾、抑郁症发病年龄、忧郁亚型或精神病性抑郁症均无显著关联。这些数据不支持小血管疾病的线性模型可能适用于绝大多数患有重度抑郁症的老年住院患者这一观点。
