Diagnostic criteria for depression in Alzheimer disease: a study of symptom patterns using latent class analysis
Sergio E Starkstein1, Milan Dragovic, Ricardo Jorge
1School of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Australia. ses@cyllene.uwa.edu.au
Context:
Although depression in Alzheimer disease (AD) has a negative emotional and functional impact on patients and caregivers, specific criteria to diagnose depression in AD are still to be validated.
Objective:
To validate a set of diagnostic criteria for major depression in AD.
Design:
Cross-sectional design using latent cluster analysis (LCA).
Setting:
Participants were recruited from consecutive referrals to a Memory Clinic of a tertiary hospital.
Participants:
A consecutive series of 971 outpatients with probable AD.
Main Outcome Measure:
Clusters of patients with or without major depression as determined with LCA.
Results:
A LCA demonstrated three clusters that were considered to represent major depression, minor depression, and no depression. All nine Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for major depression were significantly associated with the major depression cluster. Although a diagnosis of generalized anxiety disorder (GAD) and apathy were also associated with the major depression cluster, irritability was not.
Conclusions:
The DSM-IV criteria for major depression should be used unmodified to diagnose depression in AD. Future studies should determine whether GAD should be included as an additional diagnostic criterion.
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