Original articleExecutive Dysfunction and the Course of Geriatric Depression
Section snippets
Participants
The participants were older (>60 years) psychiatric patients consecutively recruited from a University-based clinic of geriatric psychiatry. All subjects provided written informed consent. Capacity to consent was evaluated by the study psychiatrist every 2 weeks. The participants were required to meet Research Diagnostic Criteria (Spitzer et al 1978) and DSM-IV criteria (American Psychiatric Association 1994) for unipolar major depression and have a score of ≥17 on the 24-item Hamilton
Results
The participants were 112 older adults (aged 73.17 ± 6.50 years [mean ± SD]; range, 62–89 years), of whom 58 were women and 54 were men. They all met DSM-IV criteria for major depression of moderate severity (HAM-D score 24.33 ± 4.70) and had high medical burden (CIRS-G score 7.60 ± 4.01). All participants were treated with citalopram over a period of 8 weeks. Their average maximal daily dose during this trial was 35.29 mg (SD = 8.39 mg). By the end of the study, 16 participants had exited.
Discussion
The main finding of this study is that abnormal scores in initiation/perseveration or response inhibition tasks predict limited change in depressive symptoms of elderly patients treated with a selective serotonin reuptake inhibitor (SSRI). Although it has no placebo arm, this is the first controlled treatment study, to our knowledge, demonstrating a relationship between abnormal executive functions and the course of symptoms of geriatric major depression. This observation confirms earlier
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