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Structural brain CT changes and cognitive deficits in elderly depressives with and without reversible dementia (‘pseudodementia’)*

Published online by Cambridge University Press:  09 July 2009

Godfrey D. Pearlson ,
Peter V. Rabins ,
Won S. Kim ,
Lynn J. Speedie ,
Paul J. Moberg ,
Alistair Burns  and
Mary J. Bascom
Godfrey D. Pearlson
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Neuroradiology, Division of Medical Psychology and Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
Peter V. Rabins*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Neuroradiology, Division of Medical Psychology and Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
Won S. Kim
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Neuroradiology, Division of Medical Psychology and Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
Lynn J. Speedie
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Neuroradiology, Division of Medical Psychology and Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
Paul J. Moberg
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Neuroradiology, Division of Medical Psychology and Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
Alistair Burns
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Neuroradiology, Division of Medical Psychology and Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
Mary J. Bascom
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Neuroradiology, Division of Medical Psychology and Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
*
1Address for correspondence: Dr Peter V. Rabins, Meyer 279, Department of psychiatry, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, Maryland 21205, USA
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Synopsis

Twenty-six elderly (> 60 yrs) patients with DSM-III major depression were compared to 13 patients with NINCDS/ADRDA probable Alzheimer's disease (AD), and to 31 screened normal controls. Subjects were matched on age and sex. Fifteen of the 26 depressed patients were cognitively impaired on the Mini-Mental State Examination (MMSE) upon admission, but after treatment returned to the normal range. These 15 patients were defined as having the dementia syndrome of depression (DOD). The remaining 11 depressed patients were termed depressed, cognitively normal (DCN). All subjects received standardized cranial CT scans for assessment of ventricular brain ratio (VBR) and CT attenuation numbers. Subjects also received neuropsychological evaluation.

CT values for the 26 depressed patients lay between those of AD patients and normal controls. CT values for the DOD subgroup clustered near those of AD patients. Patterns of cognitive deficits and correlations of CT attenuation values with cognitive measures were also similar in AD and DOD. Most patients were reassessed at a mean of two years after initial testing; of the 11 of the 15 DOD re-examined, only one had undergone cognitive decline. By contrast, all AD patients retested had declined significantly. Episodes of DOD and DCN tended to ‘breed true’. This study suggests that while patients with DOD may have underlying structural brain abnormalities, obvious short-term progression to AD does not commonly occur.

Type
Original Articles
Information
Psychological Medicine , Volume 19 , Issue 3 , August 1989 , pp. 573 - 584
Copyright
Copyright © Cambridge University Press 1989

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Footnotes

*

Previously presented at the American Psychiatric Association 139th Annual Meeting, Washington, DC, 16 May 1986.

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