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The external validity of MRI‐defined vascular depression
Author(s) -
Pimontel Monique A.,
Reinlieb Michelle E.,
Johnert Lauren C.,
Garcon Ernst,
Sneed Joel R.,
Roose Steven P.
Publication year - 2013
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.3943
Subject(s) - hamilton rating scale for depression , psychology , stroop effect , rating scale , depression (economics) , neuropsychology , hyperintensity , geriatric depression scale , magnetic resonance imaging , psychiatry , physical therapy , medicine , major depressive disorder , mood , radiology , cognition , developmental psychology , economics , macroeconomics , depressive symptoms
Objective Multiple diagnostic criteria have been used to define vascular depression (VD). As a result, there are discrepancies in the clinical characteristics that have been established for the illness. The aim of this study was twofold. First, we used empirically established diagnostic criteria to determine the clinical characteristics of magnetic resonance imaging (MRI)‐defined VD. Second, we assessed the agreement between a quantitative and qualitative method for identifying the illness. Method We examined the baseline clinical and neuropsychological profile of 38 patients from a larger, double‐blind, randomized, 12‐week clinical trial comparing nortriptyline with sertraline in depressed older adults. Ten patients met quantitative criteria for MRI‐defined VD based on the highest quartile of deep white matter hyperintensity (DWMH) volume. Fourteen patients met qualitative criteria for MRI‐defined VD based on a DWMH score of 2 or higher on the Fazekas' modified Coffey rating scale. Results Age, gender, cumulative illness rating scale‐geriatric (CIRS‐G) score, two measures of psychomotor retardation [the psychomotor retardation item of the Hamilton Rating Scale for Depression (HRSD) as well as performance on the Purdue Pegboard], and performance on the Stroop Color/Word test (a measure of the response inhibition component of executive functioning) were significantly different between those with VD and non‐VD. Conclusions Patients with VD have a distinct clinical and neuropsychological profile that is mostly consistent across different methods for identifying the illness. These findings support the notion that MRI‐defined VD represents a unique and valid subtype of late‐life depression. Copyright © 2013 John Wiley & Sons, Ltd.