engleski

Depression in middle age: possibly Alzheimer's disease or multi-infarct dementia?

Aim: The aim of this pilot study which is retrospective clinical trial was to establish the neuroplastical effect of tianeptine in patients suffering of severe depression accompanied with cognitive and mnemonic disturbances. Subjects and methods: Participants in this study were male and female depressed outpatients aged upper than 18 years, controlled during July 2006 at Policlinic Department of Clinic for Psychiatry of Clinical Hospital Centre in Rijeka, Croatia. The main included criteria was the diagnosis of depression treated with tianeptine at least 6 months as well as the depression accompanied with cognitive and mnemonic disturbances.Tianeptine has been prescribed at the effective dose of 25 or 37, 5mg/day. The evaluation included the following instruments: 1. Sociodemographic Questionnaire ; 2. The Montgomery and Asberg Depression Rating Scale (MADRS) ; 3. Organic Disorder Questionnaire ; 4. Cognitive and Mnemonic Disturbances Questionnaire and 5. Compliance Questionnaire. Qualitative variables were described using percentages. Results: The pilot study pattern included 51 patients (m-17 or 33%, f–34 or 66%) mostly in the age group of 41-60 years (49% ; m-59%, f-44%) married and employed with high school education.They have suffered from severe depression (DSM-10: F09) and severe physical disease (one or more) at the same time. Most of the female patients were treated with tianeptine with a dose of 25 mg/day and male patients with a dose of 37, 5 mg/day. Most of them previously have used some other antidepressants. Both gender groups have had adequate treatment of the organic diseases which were predominantly cardiovascular diseases, and surgical treatments in male patients. About one third of patients (31% ; m-29%, f-32%) had very severe cognitive and mnemonic disturbances which didn’t fall off after tianeptine treatment and 29% of them (m-24%, f-32%) felt cognitive and mnemonic disturbances every day constantly. The compliance was good in both gender groups, but female patients collaborated better than male ones. Discussion or instead of conclusion: Are results of this pilot study able to show at an atypical depression and could the results draw one’s attention to Alzheimer disease or multi-infarkt dementia in middle age, too (?) .

depression; Alzheimer disease; multi-infarct demantia; middle age

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