Incidence of silent cerebral infarction in patients with major depression.
OBJECTIVE
There have been few studies of the incidence of silent cerebral infarction detected by magnetic resonance imaging in patients with presenile or senile major depression.


METHODS
We examined silent cerebral infarction in patients with presenile and senile major depression who were diagnosed at Hiroshima Prefectural Hospital. The diagnostic criteria of the American Psychiatric Association (DSM-III-R) were used. Patients with stroke or focal neurological symptoms were excluded.


RESULTS
Silent cerebral infarction was observed in 51.4% of the patients with presenile-onset presenile depression, and the incidence was significantly higher than in patients with juvenile-onset presenile depression (P < .01). Among the patients with senile major depression, silent cerebral infarction was observed in 65.9% of those with presenile-onset depression and in 93.7% of those with senile-onset depression.


CONCLUSIONS
Our findings suggest that half of presenile-onset major depression and the majority of senile-onset major depression might be organic depression related to silent cerebral infarction. Because major depression occurring for the first time during or after the presenile period may be related to silent cerebral infarction, it is important to keep this possibility in mind when treating such patients.
Fujikawa
T
T
Department of Neurology and Psychiatry, Hiroshima University School of Medicine, Japan.
Yamawaki
S
S
Touhouda
Y
Y
D017668:Age of Onset; D000368:Aged; D002544:Cerebral Infarction / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors