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J Neuropsychiatry Clin Neurosci 1991; 3:33-40
Copyright © 1991 by American Neuropsychiatric Association
Brain injury and cognitive function in late-onset psychotic depression
IM Lesser, BL Miller, KB Boone, E Hill-Gutierrez, CM Mehringer, K Wong and I Mena
Department of Psychiatry, Harbor-U.C.L.A. Medical Center, Torrance 90509, USA.
Fourteen patients who developed a psychotic depression after age 45 were
compared with 72 non-psychiatrically ill elderly control subjects using
neuroimaging and neuropsychological (NP) tests. Despite the fact that the
patients were not studied if they had an obvious dementia or neurological
disease, structural brain abnormalities were found in approximately
two-thirds of patients and in less than 10% of controls. The most common
abnormality, subcortical white matter (WM) lesions, was thought to be
vascular in etiology. Also, tumor and primary degenerative dementia were
found more frequently in the patients. Compared to an age-, sex-, and
education-matched control group, the patients performed more poorly on NP
tests of frontal lobe, memory, and visual spatial abilities. Diagnostic
evaluation of the patient with late-onset psychotic depression should
include computed tomography or magnetic resonance imaging as structural
brain abnormalities are common in these patients.
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