Computed Tomography and the Outcome of Affective Disorder: A Follow-up Study of Elderly Patients

Jacoby, Robin; Levy, Raymond; Bird, Jonathan M.

doi:10.1192/bjp.139.4.288

Cited by 133 publications

(40 citation statements)

References 14 publications

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“…This finding is certainly consistent with our previous reports demonstrating the importance of differentiating major from dysthymic poststroke depression. 5 " 7 It is also consistent with the findings of Jacoby et al 21 and Post, 22 who found that depression in the elderly is frequently associated with a poor prognosis, particularly when there was associated ventricular enlargement.…”

Section: Discussionsupporting

confidence: 81%

Two-year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years.

Robinson¹,

Bolduc²

1987

Stroke

274

123

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As part of a prospective study of mood disorders in stroke patients, interviews were obtained from 37 patients at 1 year and 48 patients at 2 years follow-up. In-hospital evaluations for these 65 follow-up patients found that 9 patients (14%) had symptom clusters of major depression, 12 patients (18%) had symptom clusters of dysthymic or minor depression, and 44 patients (68%) did not meet the DSM i n diagnostic criteria for depression. Although overall prevalence of depression did not change significantly over time, the prognosis for individual patients, depending on diagnostic group, was different. All of the follow-up patients with major depression in-hospital were improved by 2 years, with a significant reduction in their mean depression scores and improvement in their activities of daily living, whereas only 30% of follow-up patients with dysthymic depression improved by this time. There was no significant improvement in their mean depression scores or mean activities of daily living score. Of the patients followed up who were not depressed in-hospital, 34% had developed major or minor depression by 2 years, and their mean depression scores were significantly increased. These data suggest that the prevalence of depression among the follow-up patients remains high (between 30 and 40%) for the first 2 years after stroke, but that untreated poststroke major depression has a natural course of about 1-2 years, with associated improvement in activity of dairy living scores, whereas the prognosis for poststroke dysthymic depression is frequently unfavorable and often persists for > 2 years. (Stroke 1987; 18:837-843) D uring the past few years, we have reported our I findings from a group of 103 patients who were examined during their acute hospitalization for stroke and followed for 2 years. '~3 At 6 months follow-up, 10 of 13 patients with symptoms of major depression in-hospital continued to have these symptoms, whereas 5 of 9 patients with minor (dysthymic) depression in-hospital continued to have these symptoms; the remaining 4 patients with dysthymic depression had developed symptoms of major depression. 2Of the 28 patients who were not depressed at the time of the initial in-hospital evaluation, 9 had developed either major or minor depressive symptoms by 6 months follow-up.2 Thus, based on our initial followup, 19 of 22 patients who were depressed in-hospital snowed no significant improvement 6 months later, and another 32% of the follow-up patients developed depression after hospital discharge.Although the Diagnostic and Statistical Manual HI (DSM ED) 4 does not recognize more than 1 category of depression in patients with brain injury (i.e., organic affective disorder), our previous investigations have From the

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Section: Discussionsupporting

confidence: 81%

Two-year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years.

Robinson¹,

Bolduc²

1987

Stroke

274

123

View full text Add to dashboard Cite

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“…It has been hypothesized that LOD may have a different etiology, characterized by less family history of depression (Baron et al, 1981) and greater comorbid illness (Jacoby et al, 1981). Greater comorbidity has been hypothesized to result in a higher degree of neuroanatomical pathology, including increased white matter hyperintensities (Krishnan et al, 1997) and interruption in white matter tracts between basal ganglia and frontal cortex, potentially involving loss of cells with 5-HT 2A receptors.…”

Section: Introductionmentioning

confidence: 99%

Decreased Hippocampal 5-HT2A Receptor Binding in Older Depressed Patients Using [18F]Altanserin Positron Emission Tomography

Sheline

Mintun

Deanna

et al. 2004

Neuropsychopharmacol

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Serotonin receptor changes have been associated with the pathophysiology and treatment of major depression. Only one other study has investigated serotonin receptor changes in older depressed patients. We used positron emission tomography (PET) and [ 18 F]altanserin, a ligand with high affinity for the 5-HT 2A receptor, to examine the relationship between 5-HT 2A receptor density and depression. Depressed subjects (n ¼ 16), age450 years, were recruited as part of a larger study. Older depressed subjects consisted of early-onset recurrent depression (EORD, n ¼ 11) and late-onset depression (LOD, n ¼ 5). An age-matched control group (n ¼ 9) was also recruited. All subjects were right-handed, nonsmokers and antidepressant-free. Regions of interest were determined on a summed MPRAGE scan transformed into Talairach space and coregistered with the PET images. Depressed subjects had less hippocampal 5-HT 2A receptor binding than controls (p ¼ 0.05). No significant differences in receptor binding were found between EORD and LOD subjects. Depressed subjects not previously treated for depression (n ¼ 6) had less hippocampal 5-HT 2A receptor binding (p ¼ 0.04) than previously treated subjects (n ¼ 10). It may be that prior medication treatment provides a compensatory upregulation of the 5-HT 2A receptor.

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“…However, 2-year follow-up studies showed that elderly depressed patients with CT changes comparable in magnitude with those of patients with AD were not cases of missed Alzheimer's disease (Jacoby et al, 1981;Pearlson et al, 1989). So at least in the short term the cerebral changes accompanying depression in some elderly patients do not predict an eventual progression to dementia.…”

Section: Discussionmentioning

confidence: 95%

Cerebral Changes in Old Age Depression: A Case Report With Findings on Single Photon Emission Tomography

Upadhyay

Abou‐Saleh

Grime

et al. 1996

Int. J. Geriat. Psychiatry

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Computed Tomography and the Outcome of Affective Disorder: A Follow-up Study of Elderly Patients

Cited by 133 publications

References 14 publications

Two-year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years.

Two-year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years.

Decreased Hippocampal 5-HT2A Receptor Binding in Older Depressed Patients Using [18F]Altanserin Positron Emission Tomography

Cerebral Changes in Old Age Depression: A Case Report With Findings on Single Photon Emission Tomography

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