Catatonia in depression: prevalence, clinical correlates, and validation of a scale.

Objectives: To examine the clinical correlates of catatonia in depression, to validate a scale for catatonia, and to assess the validity of the DSM-IV criteria of the catatonic features specifier for mood disorders.

Methods: A series of 79 consecutive patients with depression and 41 patients with Parkinson's disease without depression were examined using the modified Rogers scale (MRS), the unified Parkinson's disease rating scale (UPDRS), and the structured clinical interview for DSM-III-R (SCID).

Results: Sixteen of the 79 depressed patients (20%) had catatonia.

The prevalence and clinical correlates of apathy and irritability in Alzheimer's disease.

We examined the prevalence and correlates of apathy and irritability in a consecutive series of 101 patients with probable Alzheimer's disease (AD). Based on clinical criteria, 46 (46%) patients had apathy, and 13 (13%) patients had irritability. Apathy was significantly associated with more severe impairments in activities of daily living, significantly more severe extrapyramidal signs, and a significantly higher frequency of both major depression and dysthymia.

Prevalence and clinical correlates of pathological affective display in Alzheimer's disease.

This study examined the prevalence and correlates of pathological affect in Alzheimer's disease. A consecutive series of 103 patients with Alzheimer's disease were examined with a comprehensive psychiatric assessment that included the pathological laughing and crying scale (PLACS). Forty patients (39%) showed pathological affect: 25% showed crying episodes, and 14% showed laughing or mixed (laughing and crying) episodes.

Neuropsychiatric and neuropsychological correlates of delusions in Alzheimer's disease.

We examined the prevalence, phenomenology, and clinical correlates of delusions in a consecutive series of 103 patients with probable Alzheimer's disease (AD). Patients were examined with the Present State Exam and the Dementia-Psychosis Scale. Twenty-one patients (20%) met DSM-III-R criteria for a delusional disorder.

A single-photon emission computed tomographic study of anosognosia in Alzheimer's disease.

Objective: To examine the presence of specific regional cerebral blood flow correlates of anosognosia in patients with probable Alzheimer's disease.

Design: Case series, group comparisons.

Setting: Ambulatory care referral center.

SPECT findings before and after ECT in a patient with major depression and Cotard's syndrome.

A patient's major depression and Cotard's syndrome (the delusion of being dead) both resolved completely after 12 ECT treatments. A SPECT study 1 week before ECT showed reduced blood flow in the frontoparietal medial and dorsolateral frontal cortex, basal ganglia, and thalamus; SPECT 1 month after ECT showed perfusion increments in those regions. This case study demonstrates that Cotard's syndrome in the context of major depression may be successfully treated with ECT and suggests that the psychiatric improvement was accompanied by increased blood flow in specific brain areas.

Prevalence and correlates of dysthymia and major depression among patients with Alzheimer's disease.

Objective: The purpose of this study was to examine the prevalence, risk factors, and correlates of depression among patients with Alzheimer's disease.

Method: A consecutive series of 103 patients with probable Alzheimer's disease were examined with a structured psychiatric interview and were assessed for the presence of cognitive impairments, deficits in activities of daily living, social functioning, and anosognosia.

Results: Fifty-one percent of the patients had depression (28% had dysthymia and 23% major depression).

Anosognosia in Alzheimer's disease: a study of associated factors.

The authors examined the prevalence and correlates of anosognosia in a consecutive series of patients with probable Alzheimer's disease (AD). Patients were examined with the Anosognosia Questionnaire-Dementia (AQ-D), which showed good reliability and validity. On the basis of the AQ-D scores, patients were divided into those with anosognosia (n = 21) and those without anosognosia (n = 52).

Extrapyramidalism in Alzheimer's disease: prevalence, psychiatric, and neuropsychological correlates.

The prevalence and clinical correlates of extrapyramidal signs in a consecutive series of 78 patients with Alzheimer's disease attending a neurology clinic, and 20 age comparable normal controls, were examined. Based on the unified Parkinson's disease rating scale (UPDRS) findings, 18 patients (23%) met criteria for parkinsonism, 44 (56%) had isolated extrapyramidal signs, and 16 (21%) had no extrapyramidal signs. Whereas the control group showed a similar prevalence of isolated extrapyramidal signs (57%), none of them showed parkinsonism.

A SPECT study of delusions in Alzheimer's disease.

Although delusions are a frequent finding in patients with Alzheimer's disease (AD), their mechanism is not well known. We carried out Tc 99m HMPAO single-photon emission computed tomography studies in 16 AD patients with delusions and 29 AD patients without delusions comparable in age, years of education, duration of illness, and severity of dementia. Although we found no significant between-group differences in performance on neuropsychological tasks, AD patients with delusions had significantly lower mean cerebral blood flow in both the left and right temporal lobes.

Specificity of changes in cerebral blood flow in patients with frontal lobe dementia.

Eight patients with a clinical diagnosis of probable Alzheimer's disease, eight patients with the clinical diagnosis of frontal lobe dementia, and eight controls were examined with single photon emission tomography (SPECT) using 99Tc-HMPAO. Patients with Alzheimer's disease and those with frontal lobe dementia met DSM-III-R criteria for mild dementia and were in the early stages of the illness. Compared with patients with Alzheimer's disease, the group with frontal lobe dementia had significantly lower blood flow in the frontal lobes (dorsolateral and orbital), the anterior temporal cortex, and the basal ganglia.

Quantified electroencephalographic correlates of depression in Alzheimer's disease.

While depression is one of the most frequent psychiatric problems among patients with probable Alzheimer's disease (AD), its mechanism is not well known. We performed quantified EEGs in a consecutive series of seven patients with mild dementia and depression, six patients with mild dementia and no depression, eight patients with moderate dementia and depression, and eight patients with moderate dementia and no depression. Regardless of the severity of dementia, depressed patients had a significantly higher percent theta in posterior brain areas.

ECT in a patient with a frontal craniotomy and residual meningioma.

Electroconvulsive therapy (ECT) was used to treat a patient with a large left frontal craniotomy and remaining frontal meningioma. Treatment was successful and uneventful. ECT should be considered in the treatment of drug-resistant depressed patients with craniotomies and remaining tumor.

SPECT findings in patients with primary mania.

Five patients with a manic episode and 7 age-comparable control subjects were studied with single-photon emission computed tomography and [99mTc]d,l-hexamethylpropyleneamine oxime. Manic patients showed significantly lower blood flow in the basal portion of the right temporal lobe compared with normal control subjects. Moreover, manic patients showed a left-right asymmetry (a significantly lower perfusion in the right versus left temporal basal cortex), as well as a dorsal-ventral asymmetry (a significantly lower perfusion in the right temporal basal versus dorsal cortex).