title: Prospective study of major depressive disorder with white matter hyperintensity: comparison of patients with and without lacunar infarction.
abstract: OBJECTIVE
  To investigate clinical characteristics, outcome, and risk factor for cerebrovascular disease in patients who had major depressive disorder and white matter hyperintensity (WMHI).
  
  
  METHODS
  A total of 123 new patients diagnosed with major depressive disorder by semi-structured interview underwent magnetic resonance imaging (MRI) and were placed into one of three groups based on results. Patients with no abnormal findings (NF), patients with WMHI and no lacunar infarction (WMHI), and patients with lacunar infarction (LI).
  
  
  RESULTS
  In the WMHI group, age at initial onset of depression and age at time of interview were both higher than in the NF group, as was severity of depression. Hamilton Rating Scale for Depression (HRSD) scores were significantly higher in the WMHI group than in the NF group. Total WMHI was significantly correlated only with age at initial onset of depression and age at time of interview. In the WMHI group, age at interview was lower than in the LI group and systolic and diastolic blood pressures were lower. Survival analysis regarding the clinical outcome of remission was conducted, but no significant differences were discovered among the three groups, WMHI, LI, and NF. However, the suicide rate was significantly higher in the LI group than in the other two groups.
  
  
  CONCLUSIONS
  The origin and clinical characteristics of depression accompanied by WMHI may be specific; additional stringent study in comparison with individuals with LI is needed.
authors.affiliation: Department of Neuropsychiatry, Oita University Faculty of Medicine, Oita, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Komaki
authors.forename: Haruo
authors.initials: H
authors.lastname: Nagayama
authors.forename: Hirochika
authors.initials: H
authors.lastname: Ohgami
authors.forename: Hajime
authors.initials: H
authors.lastname: Takaki
authors.forename: Hiromu
authors.initials: H
authors.lastname: Mori
authors.forename: Jotaro
authors.initials: J
authors.lastname: Akiyoshi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001921:Brain / Q000473:pathology*; D020520:Brain Infarction / Q000150:complications / Q000473:pathology / Q000523:psychology*; D003865:Major Depressive Disorder / Q000150:complications / Q000473:pathology* / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013405:Suicide / Q000523:psychology