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Major depression and bipolar disorders in CADASIL: a study using the DSM-IV semi-structured interview
R Valenti1, F Pescini, S Antonini
1Department of Neurological and Psychiatric Sciences, University of Florence, Italy.
Mood disorders are common in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). This study found high rates of depression and bipolar disorder, suggesting increased psychiatric focus is needed for CADASIL patients.
Area of Science:
- Neurology
- Psychiatry
- Genetics
Background:
- Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a genetic cerebral microangiopathy.
- Key features include migraine, stroke, and cognitive decline.
- Psychiatric disturbances are recognized but understudied in CADASIL.
Purpose of the Study:
- To systematically evaluate mood disorders in patients with CADASIL.
- To determine the prevalence of depression and bipolar disorder in this population.
Main Methods:
- Twenty-three CADASIL patients underwent psychiatric assessment.
- Structured Clinical Interview for DSM-IV (SCID) was utilized.
- Hamilton Rating Scale for Depression (HRSD) and Young Mania Rating Scale (YMRS) quantified symptoms.
Main Results:
- 73.9% of patients had a lifetime depressive episode; 26.1% had a current episode.
- 26.1% of patients received a lifetime diagnosis of mania.
- Mean HRSD score was 9.1 for current depression; mean YMRS score was 14.2 for mania.
Conclusions:
- Mood disorders are highly prevalent in CADASIL.
- This study identified higher depression rates than previously reported and significant bipolar disorder frequency.
- Increased attention to psychiatric care is recommended for CADASIL patients.
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