Magazine article Clinical Psychiatry News

New Criteria Target Depression in Alzheimer's. (Best Treatment Approaches Still Unclear)

Magazine article Clinical Psychiatry News

New Criteria Target Depression in Alzheimer's. (Best Treatment Approaches Still Unclear)

Article excerpt

New criteria for diagnosing depression in Alzheimer's patients should increase recognition of the problem, said Dr. Gary Kennedy, president of the American Association of Geriatric Psychiatry.

Developed by a team of researchers led by the National Institute of Mental Health, the criteria are the first to characterize the depression that can occur m the course of Alzheimer's disease.

"It turns out that depression symptoms are relatively frequent in dementia, although that doesn't mean the majority of patients have them," said Dr. Kennedy, who also is director of geriatric psychiatry at Montefiore Medical Center, New York. But for those that do, "major depressive disorders criteria don't capture much of the depression in persons with dementia."

Average estimates of the prevalence of depression of Alzheimer's disease (AD) range from 30% to 50%, but the accuracy of those estimates remains questionable because the way in which symptoms are defined and assessed is inconsistent. The accuracy of the estimates also is clouded by differences in caregiver and patient reporting of symptoms.

The researchers, who developed the criteria using an "iterative consensus process," pointed out that they were not intended to be a model for future DSM terminology Instead, they were designed to spur clinical and pharmacologic research that will allow clinicians to better determine a patient's prognosis and plan treatment strategies (Am. J. Geriatr. Psychiatry 10[2]:125-28, 2002).

The researchers noted that, in addition to all criteria met for Alzheimer's disease, patients who have depression of AD must have three or more of the following symptoms within a 2-week period:

* Clinically significant depressed mood.

* Decreased positive affect or pleasure in response to social contacts and usual activities.

* Social isolation or withdrawal. …

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