The external validity of MRI-defined vascular depression
Article first published online: 28 FEB 2013
Copyright © 2013 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 28, Issue 11, pages 1189–1196, November 2013
How to Cite
Pimontel, M. A., Reinlieb, M. E., Johnert, L. C., Garcon, E., Sneed, J. R. and Roose, S. P. (2013), The external validity of MRI-defined vascular depression. Int. J. Geriat. Psychiatry, 28: 1189–1196. doi: 10.1002/gps.3943
- Issue published online: 4 OCT 2013
- Article first published online: 28 FEB 2013
- Manuscript Accepted: 11 JAN 2013
- Manuscript Received: 7 SEP 2012
- late-life depression;
- vascular depression;
- clinical characteristics;
- external validity
Multiple diagnostic criteria have been used to define vascular depression (VD). As a result, there are discrepancies in the clinical characteristics that have been established for the illness. The aim of this study was twofold. First, we used empirically established diagnostic criteria to determine the clinical characteristics of magnetic resonance imaging (MRI)-defined VD. Second, we assessed the agreement between a quantitative and qualitative method for identifying the illness.
We examined the baseline clinical and neuropsychological profile of 38 patients from a larger, double-blind, randomized, 12-week clinical trial comparing nortriptyline with sertraline in depressed older adults. Ten patients met quantitative criteria for MRI-defined VD based on the highest quartile of deep white matter hyperintensity (DWMH) volume. Fourteen patients met qualitative criteria for MRI-defined VD based on a DWMH score of 2 or higher on the Fazekas' modified Coffey rating scale.
Age, gender, cumulative illness rating scale-geriatric (CIRS-G) score, two measures of psychomotor retardation [the psychomotor retardation item of the Hamilton Rating Scale for Depression (HRSD) as well as performance on the Purdue Pegboard], and performance on the Stroop Color/Word test (a measure of the response inhibition component of executive functioning) were significantly different between those with VD and non-VD.
Patients with VD have a distinct clinical and neuropsychological profile that is mostly consistent across different methods for identifying the illness. These findings support the notion that MRI-defined VD represents a unique and valid subtype of late-life depression. Copyright © 2013 John Wiley & Sons, Ltd.