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(Stroke. 1997;28:1123-1125.)
© 1997 American Heart Association, Inc.

Articles

Psychosocial Stressors in Patients With Major Depression and Silent Cerebral Infarction

Tokumi Fujikawa, MD, PhD; Ichiro Yanai, MD; Shigeto Yamawaki, MD, PhD

From the Department of Psychiatry and Neurosciences, Hiroshima University School of Medicine (T.F., I.Y., S.Y.), and Department of Psychiatry, National Sanatorium Kamo Hospital (T.F., I.Y.), Hiroshima, Japan.

Correspondence to T. Fujikawa, MD, PhD, Department of Psychiatry, National Sanatorium Kamo Hospital, 92 Minamikata, Kurose-cho, Kamo-gun, Hiroshima 724-06, Japan.

Background and Purpose We previously found that silent cerebral infarction (SCI) was present in most of the patients older than 50 years with major depression who were examined. The present study was designed to clarify the relationship between psychosocial stressors and SCI in patients with major depression.

Methods Forty-two patients with unipolar depression underwent MRI and were classified as SCI-negative (n=19) or SCI-positive (n=23). The SCI-positive group was subclassified into those with moderate SCI (n=16) and those with severe SCI (n=7). The relationship between the patients' DSM-III-R axis IV scores and SCI was evaluated.

Results The axis IV score was significantly lower in the SCI-positive group than in the SCI-negative group (P<.05). Within the SCI-positive group, the mean axis IV score was significantly lower in those with severe SCI than in those with moderate SCI (P<.05).

Conclusions Our findings suggest that depression in patients with SCI involves more neurological factors than psychosocial stressors.

Key Words: cerebral infarction • magnetic resonance imaging • depression • stress, psychological

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