Vascular depression: overrepresented among African Americans?
Vascular depression: overrepresented among African Americans?
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DOI：
10.1002/gps.4029
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发表时间：
2014-05-01
影响因子：
4
通讯作者：
Sneed, Joel R.
中科院分区：
文献类型：
--
作者：
Reinlieb, Michelle E.;Persaud, Amanda;Sneed, Joel R.
我们的主要目的是比较非裔美国人和白种人老年抑郁症患者的血管性抑郁症发生率。次要目的包括表征血管性抑郁症的临床和神经心理学特征，并比较血管性和非血管性抑郁症患者的抗抑郁反应率。方法：这是一项双中心、多民族、为期8周的老年抑郁症患者抗抑郁药物开放试验。符合DSM-IV非精神病性单极抑郁症标准的50岁或以上的男性和女性参加了这项试验。每位参与者在基线时进行了全面的精神病学和神经心理学评估以及脑MRI。结果46例患者符合纳入和排除标准。其中42名患者在基线时接受了核磁共振检查。16例患者符合血管抑郁标准。在神经心理测试中，血管性抑郁症患者是非裔美国人、女性的可能性更高、高血压和精神运动迟缓的比例更高、情感性疾病家族史的比例更低、额叶系统功能障碍的比例更低。血管性抑郁与非血管性抑郁患者的有效率差异无统计学意义。结论：这是第一个在非裔美国人和白种人的临床样本中记录高血管性抑郁症发病率的研究。我们的研究结果表明，血管性抑郁症在非裔美国人中可能被过度代表，这与该人群中心血管疾病、高血压和中风的高发率是一致的。版权所有：John Wiley & Sons， Ltd。
ObjectiveOur primary aim was to compare the rate of vascular depression among a clinical sample of African American and Caucasian depressed older adults. Secondary aims included characterizing the clinical and neuropsychological profile of vascular depression and comparing antidepressant response rates between patients with vascular and nonvascular depression.MethodsThis was a two-site, multi-ethnic, open 8-week trial of antidepressant medication in older adults with depression. Men and women 50years or older meeting DSM-IV criteria for nonpsychotic unipolar depression participated in this trial. Each participant underwent a comprehensive psychiatric and neuropsychological evaluation and a brain MRI, which were performed at baseline.ResultsForty-six patients met inclusion and exclusion criteria. Forty-two of those patients received an MRI at baseline. Sixteen patients met criteria for vascular depression. Patients with vascular depression were significantly more likely to be African American and have a higher likelihood of being female, a higher rate of hypertension and psychomotor retardation, a lower rate of family history of affective illness, and frontal systems dysfunction on neuropsychological testing. The difference in response rates between patients with vascular and nonvascular depression did not reach statistical significance.ConclusionsThis is the first study to document high rates of vascular depression in a clinical sample of African Americans and Caucasians. Our findings suggest that vascular depression may be overrepresented among African Americans, which is consistent with the high rates of cardiovascular disease, hypertension, and stroke in this population. Copyright (c) 2013 John Wiley & Sons, Ltd.