- 作者：Paul Naarding ; Robert A. Schoevers ; Joost G.E. Janzing ; Cees Jonker ; Peter J. Koudstaal and Aartjan T.F. Beekman
- 刊名：Journal of Affective Disorders
- 出版年：2005
- 出版时间：2005
- 年：2005
- 卷：88
- 期：2
- 页码：155-162
- 全文大小：110 K
BackgroundIf specific symptom profiles of depressive disorders in the elderly are related to a specific etiology, this could have implications for everyday clinical practice. We hypothesized that a ‘motivational’ profile, with symptoms such as psychomotor change, loss of interest and loss of energy, could clinically separate patients with predominantly vascular or degenerative risk indicators from patients with inflammatory risk indicators.Methods
A total of 4051 subjects participated in a study on mental health problems in community-dwelling elderly. Information on psychiatric symptoms, demographic and medical status, previous history and family history was obtained. We distinguished three subgroups according to predominant somatic risk-indicators; vascular, degenerative and inflammatory groups.
Results
Motivational symptoms were associated with vascular or degenerative risk-indicators for depression; psychomotor change with both indicators; loss of energy with vascular, though also with the inflammatory indicator, and thinking/concentration disturbance with the degenerative indicator. The so-called mood symptoms of depression, especially thoughts of death, were more strongly related with the inflammatory risk-indicator. Melancholic symptoms like appetite and sleep disturbances were more strongly associated with the inflammatory risk-indicator.
Limitations
Etiological classification was not confirmed by additional investigations such as laboratory findings or MRI brain scans.
Conclusion
This study showed that in patients with a late-life depression specific symptoms of the depressive disorder may reflect the predominant underlying pathogenic mechanism.