title: Major depression and bipolar disorders in CADASIL: a study using the DSM-IV semi-structured interview.
abstract: OBJECTIVE
  Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebral microangiopathy characterized by migraine, cerebrovascular events, and cognitive impairment. Although recognized as a cardinal feature of the disease, psychiatric disturbances have rarely been the object of focused studies. We performed a structured evaluation of mood disorders in CADASIL.
  
  
  METHODS
  Twenty-three patients with CADASIL (five men and 18 women) were assessed by psychiatrists using the Structured Clinical Interview for the DSM-IV, clinician version. For the quantitative assessment of current mood disorder symptoms, the Hamilton Rating Scale for Depression (HRSD) and the Young Mania Rating Scale (YMRS) were used.
  
  
  RESULTS
  A lifetime depressive episode was recorded in 17/23 (73.9%) patients with CADASIL. Six (26.1%) patients with CADASIL reported a current depressive episode. A diagnosis of manic lifetime episode was made in 6 (26.1%) patients with CADASIL. The HRSD mean score in patients with current depression was 9.1 ± SD 8.1. The YMRS mean score was 14.2 ± SD 4.1 for manic CADASIL.
  
  
  CONCLUSIONS
  This study confirms that mood disorders are frequent in CADASIL. The use of a structured psychiatric interview outlines a frequency of depression higher than that previously reported but also reveals a considerable frequency of bipolar disorders. If confirmed in larger series, these data suggest that a greater attention should be paid to the psychiatric aspects in CADASIL.
authors.affiliation: Department of Neurological and Psychiatric Sciences, University of Florence, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Valenti
authors.forename: F
authors.initials: F
authors.lastname: Pescini
authors.forename: S
authors.initials: S
authors.lastname: Antonini
authors.forename: G
authors.initials: G
authors.lastname: Castellini
authors.forename: A
authors.initials: A
authors.lastname: Poggesi
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: D
authors.initials: D
authors.lastname: Inzitari
authors.forename: S
authors.initials: S
authors.lastname: Pallanti
authors.forename: L
authors.initials: L
authors.lastname: Pantoni
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology / Q000209:etiology*; D046589:CADASIL / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests