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Depression Influences Intellectual Impairment in Stroke Patients

Published online by Cambridge University Press:  29 January 2018

Robert G. Robinson ,
Karen Bolla-Wilson ,
Edith Kaplan ,
John R. Lipsey  and
Thomas R. Price
Robert G. Robinson*
Affiliation:
Departments of Psychiatry and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
Karen Bolla-Wilson
Affiliation:
Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine
Edith Kaplan
Affiliation:
Psychology Service, VAMC and Department of Neurology, Boston University School of Medicine, Boston, Massachusetts 02130, USA
John R. Lipsey
Affiliation:
Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine
Thomas R. Price
Affiliation:
Department of Neurology, University of Maryland School of Medicine
*
∗Correspondence
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Abstract

Patients with ischaemic lesions of the left cerebral hemisphere were examined for depression and intellectual impairment: in non-depressed patients, the severity of impairment was related to both lesion volume and location, as assessed by CT scan analysis. Cognitive impairment in patients with major depression was greater than predicted by lesion volume alone, and when patients were matched for severity of impairment, depressed patients had smaller lesion volumes than the non-depressed. After six months, non-depressed patients had significantly less cognitive impairment than depressed patients who showed no improvement. Both depression and lesion volume were significantly and independently related to cognitive impairment. These findings suggest that post-stroke depression can produce a true dementia in Its own right, and that treatment of post-stroke depression might benefit cognitive function.

Type
Papers
Information
The British Journal of Psychiatry , Volume 148 , Issue 5 , May 1986 , pp. 541 - 547
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1980) Diagnostic Criteria from Diagnostic and Statistical Manual of Mental Disorders, Third edition, Washington, DC: APA.Google Scholar
Benson, D. F. (1973) Psychiatric aspects of aphasia. British Journal of Psychiatry, 123, 555–566.CrossRefGoogle ScholarPubMed
Caine, E. D. (1981) Pseudo-dementia. Archives of General Psychiatry, 38, 1359–1364.Google Scholar
Charatan, F. B. & Fisk, A. (1978) The mental and emotional results of strokes. New York State Journal of Medicine, 78, 1403–1405.Google Scholar
Finkelstein, S., Benowitz, L. I., Baloessarini, R. et al (1982) Mood, vegetative disturbance and dexamethasone suppression test after stroke. Annal of Neurology, 12, 463–468.CrossRefGoogle Scholar
Finkelstein, S., Campbell, A., Stoll, A. L., Baldessarini, R. J., Stinus, L., Paskevitch, P. A. & Domesick, V. B. (1983) Changes in cortical and subcortical levels of monoamines and their metabolites following unilateral ventrolateral cortical lesions in the rat. Brain Research, 271, 279–288.Google Scholar
Folstein, M. F., Folstein, S. F. & McHugh, P. R. (1975) Mini-menul state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Folstein, M. F., Maiberger, R. & Mchugh, P. R. (1977) Mood disorder as specific complication of stroke. Journal of Neurology, Neurosurgery & Psychiatry. 40, 1018–1020.Google Scholar
Hamilton, M. A. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery & Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Kiloh, L. G. (1961) Pseudo-dementia. Acta Psychiatria Scandanavia. 37, 336–351.Google Scholar
Kunitz, S. C., Gross, C. R., Heyman, A., Kase, C. S., Mohr, J. P., Price, T. R. & Wolf, P. A. (1984) The pilot stroke data bank: Definition, design and data. Stroke. 15(4): 740–746.CrossRefGoogle ScholarPubMed
Lipsey, J. R., Robinson, R. G., Pearlson, G. D., Rao, K. & Price, T. R. (1983) Mood change following bilateral hemisphere brain injury. British Journal of Psychiatry. 143, 266–273.Google Scholar
Lipsey, J. R., Robinson, R. G., Pearlson, G. D., Rao, K. & Price, T. R. (1984) Nortriptyline treatment of post-stroke depression: A double-blind treatment trial. Lancet, i. 297–300.Google Scholar
Lipsey, J. R., Robinson, R. G., Pearlson, G. D., Rao, K. & Price, T. R. (1985) Dexamethasone suppression test and mood following stroke. American Journal of Psychiatry. 142, 318–323.Google Scholar
McHugh, P. R. & Folstein, M. F. (1979) Psychopathology of dementia: Implications for neuropathology. In Congenital & Acquired Cognitive Disorders (ed. Katzman, R.). New York: Raven Press.Google Scholar
Nott, P. N. & Fleminger, J. J. (1975) Presenile dementia: The difficulties of early diagnosis. Acta Psychiatria Scandanavia. 51, 210–217.Google Scholar
Robinson, R. G., Shoemaker, W. J., Schlumpf, M., Valk, T. & Bloom, F. E. (1975) Experimental cerebral infarction in rat brain; Effect on catecholamines and behavior. Nature, 255, 332–334.CrossRefGoogle Scholar
Robinson, R. G. (1979) Differential behavioral and biochemical effects of right and left hemispheric cerebral infarction in the rat. Science, 205, 707–710.CrossRefGoogle ScholarPubMed
Robinson, R. G., Shoemaker, W. J. & Schlumpf, M. (1980) Time course of changes in catecholamines following right hemispheric cerebral infarction in the rat. Brain Research, 181, 202–208.CrossRefGoogle ScholarPubMed
Robinson, R. G. & Benson, D. F. (1981) Depression in aphasie patients; Frequency, severity and clinical-pathological correlations. Brain A Language, 14, 282–291.Google Scholar
Robinson, R. G. & Szetela, B. (1981) Mood change following left hemisphere brain injury. Annals of Neurology, 9, 447–453.Google Scholar
Robinson, R. G. & Price, T. R. (1982) Post-stroke depressive disorders; A follow-up study of 103 outpatients. Stroke, 13, 635–641.CrossRefGoogle Scholar
Robinson, R. G., Kubos, K. L., Starr, L. B., Rao, K. & Price, T. R. (1983a) Mood changes in stroke patients; Relationship to lesion location. Comprehensive Psychiatry, 24, 555–566.CrossRefGoogle ScholarPubMed
Robinson, R. G., Starr, L. B., Kubos, K. L. & Price, T. R. (1983b) A two year longitudinal study of post-stroke mood disorders: Findings during the initial evaluation. Stroke, 14, 736–741.Google Scholar
Robinson, R. G., Kubos, K. L., Starr, L. B., Rao, K. & Price, T. R. (1984a) Mood disorders in stroke patients: Importance of location of lesion. Brain. 107, 81–93.Google Scholar
Robinson, R. G., Stark, L. B. & Price, T. R. (1984b) A two year longitudinal study of post-stroke mood disorders: Prevalance and duration at six months follow-up. British Journal of Psychiatry. 144, 256–262.CrossRefGoogle Scholar
Robinson, R. G., Stark, L. B., Lipsey, J. R., Rao, K. & Price, T. R. (1984c) A two year longitudinal study of post-stroke mood disorders: Dynamic changes in associated variables over the first 6 months of follow-up. Stroke. 15, 510–517.Google Scholar
Robinson, R. G., Stark, L. B., Lipsey, J. R., Rao, K. & Price, T. R. (1985) A two year longitudinal study of post-stroke mood disorders: In-hospital prognostic factors associated with six month outcome. Journal of Nervous A Mental Disease. 173, 221–226.Google Scholar
Ross, E. D. & Rush, A. J. (1981) Diagnosis and neuroanatomical correlates of depression in brain damaged patients. Archives of General Psychiatry. 38, 1344–1354.Google Scholar
Wells, C. E. (1979) Pseudo-dementia. American Journal of Psychiatry, 136, 895–900.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and classification of psychiatric symptoms. Instruction Manual for the PSE. London: Cambridge University Press.Google Scholar
Zervas, N. T., Hori, H., Negora, M., Wurtman, R. J. et al (1974) Reduction of brain dopamine following experimental cerebral ischemia. Nature. 247–283.Google Scholar
Zung, W. W. K. (1965) A self-rating depression scale. Archives of General Psychiatry. 12, 63–70.CrossRefGoogle ScholarPubMed
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