Vascular basis of late-onset depressive disorder
Vascular basis of late-onset depressive disorder
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DOI：
10.1192/bjp.180.2.157
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发表时间：
2002-02-01
影响因子：
10.5
通讯作者：
O'Brien, J
中科院分区：
文献类型：
--
作者：
Baldwin, RC;O'Brien, J
背景越来越多的证据表明，可能有一种亚型的抑郁症出现在以后的生活中，其特征是一个独特的临床表现和与脑血管疾病的关联。这被称为“血管性抑郁症”。目的是审查心血管疾病和抑郁症之间的关联，脑血管疾病和抑郁症之间的证据，并检查临床实践和research.Method的影响，作者回顾了医学文献，涵盖了过去5 years.Results有强有力的证据表明，心血管疾病和抑郁症之间的关联，但这并不局限于老年人。因果关系可能是双向的.也有证据表明，脑血管疾病和抑郁症之间存在因果关系，特别是发生在生命后期。主要的重点一直是神经放射学的发现被认为是由于血管疾病，虽然病理可能是heterogeneous.Conclusions虽然有差距的证据有强有力的支持血管性抑郁症的概念，其特征是减少抑郁症的意念，皮质下神经功能障碍，冷漠和心理变化，这对治疗和预防都有影响。
Background Growing evidence suggests that there may be a subtype of depression arising in later life that is characterised by a distinct clinical presentation and an association with cerebrovascular disease. This has been termed 'vascular depression'.Aims To review the evidence for associations between cardiovascuiar disease and depression and between cerebrovascular disease and depression, and to examine implications for clinical practice and research.Method The authors reviewed the medical literature covering the past 5 years.Results There is strong evidence for an association between cardiovascular disease and depression, but this is not confined to older people. The causal pathway may be bi- directional. There is also a convergence of evidence suggesting a causal link between cerebrovascular disease and depression, especially that occurring later in life. The major focus has been on neuroradiological findings thought to be due to vascular disease, although the pathology may be heterogeneous.Conclusions Although there are gaps in the evidence there is strong support for the concept of vascular depression, characterised by reduced depression ideation, subcortical neurological dysfunction, apathy and psychomotor change,This has implications for both treatment and prevention.Declaration of interest None.