CJD AND NEUROPSYCHIATRIC SYMPTOMS

editorial comment
Creutzefeldt-Jakob disease (CJD) is a rare dementia caused by a transmissible prion protein and notable for its rapidly progressive nature. While neuropsychiatric symptoms are common, there is surprisingly little literature on this aspect of the illness. In a retrospective analysis of 126 cases of CJD collected over 25 years, Wall et al (2006) noted symptoms in 80% of the sample. Frequent problematic behaviours included sleep disturbance, psychosis, depression, anxiety and agitation. Though rightfully cautious about their observations, the authors noted that while anxiolytics (benzodiazepines) and antipsychotics appeared to provide modest benefits, antidepressants and anticonvulsants provided less consistent benefits with respect to behaviour.

Psychiatric manifestations of Creutzfeldt-Jakob disease: a 25-year analysis
(J NEUROPSYCHIATRY CLIN NEUROSCI 2005;17(4):489-495)

CHRISTOPHER A. WALL, MD,
TERESA A. RUMMANS, MD,
ALLEN J. AKSAMIT, MD,
LOIS E. KRAHN, MD,
et al,
ROCHESTER, MN

 

DEPRESSION AS A RISK FACTOR FOR COGNITIVE DISORDERS

editorial comment
Two recent studies address the relationship between depression and risk of developing cognitive disorders. In a prospective epidemiological study (Barnes et al 2006), depressive symptoms at baseline were examined for their effect on the development of mild cognitive impairment (MCI) after six years of follow-up. Depressive symptoms were not only significantly related to risk of developing MCI, but did so in a “doseresponse” manner with increased symptoms being associated with greater likelihood of MCI development. In a careful meta-analysis of published case control and cohort studies, Ownby et al (2006) concluded that a history of depression increased the likelihood of developing AD two-fold. Perhaps more interesting, these authors noted that the interval between the diagnoses of depression and AD correlated positively with risk of AD, suggesting that depression is more likely an independent risk factor rather than a prodrome of the dementia.

Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study
(ARCH GEN PSYCHIATRY 2006;63:273-280)

DEBORAH E. BARNES, PhD, MPH,
GEORGE S. ALEXOPOULOS, MD,
OSCAR L. LOPEZ, MD,
JEFF D. WILLIAMSON, MD, MHS,
ET AL,
VARIOUS CENTReS, USA

Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis
(ARCH GEN PSYCHIATRY 2006;63:530-538)

RAYMOND OWNBY, MD, PhD, MBA,
ELIZABETH CROCCO, MD,
AMARILIS ACEVEDO, PhD,
VINeETH JOHN, MD,
ET AL,
MIAMI, FL

 

 

 

 

 

 

 

 
 
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