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
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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