CLINICAL PREDICTORS OF SOMATIC AND PSYCHOLOGICAL SYMPTOMS OF DEPRESSION IN ALZHEIMER'S DISEASE

✍ Scribed by A. TROISI; A. PASINI; G. GORI; T. SORBI; A. BARONI; N. CIANI

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 398 KB
• Volume: 11
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/(sici)1099-1166(199601)11:1<23::aid-gps264>3.0.co;2-4

✦ Synopsis

The Hamilton Rating Scale for Depression was employed to assess the severity of somatic and psychological symptoms of depression in 42 outpatients with dementia of the Alzheimer type. The severity of somatic symptoms increased in the more severe stages of dementia whereas the severity of psychological symptoms did not vary.

Psychological symptoms were more severe in female patients and in patients with a better awareness of cognitive decline. In contrast, the degree of cognitive dysfunction was the only significant predictor of the severity of somatic symptoms. These results suggest that, in Alzheimer's disease, somatic symptoms are secondary to dementia rather than manifestations of a coexistent depressive disorder and point to the limited value of the Hamilton scale for detecting depression in demented patients.

KEY woms-Alzheimer's disease; depression; diagnosis; Hamilton Rating Scale for Depression; somatic symptoms; psychological symptoms A major problem that complicates the diagnosis of depression in demented patients is the similarity of signs and symptoms in both illnesses and the difficulty of ascertaining what signs and symptoms are specifically related to depression and what signs and symptoms are specifically related to dementia (Lazarus et al., 1987). Patients with dementia and/or depression may present with similar somatic symptoms, such as anorexia, weight loss, fatigue, psychomotor retardation, insomnia and somatic complaints . Some authors have assumed that, in Alzheimer patients, these changes are a result of the process of dementia and not a concurrent depression. suggested that, in making the additional diagnosis of major depression in a patient with dementia of the Alzheimer type, emphasis should