Objective
To determine the difference in outcome among elderly people with major depression who do and do not have severe white matter lesions on MRI.
Methods
Sixty depressed subjects aged 55 and over referred to hospital psychiatric services with major depressive disorder (DSM IIIR) were followed for 32 months on average and the proportion with good outcome (as determined by full recovery from initial illness and no evidence of depressive relapse or cognitive decline during followup) among those with and without severe deep white matter lesions.
Results
Mean (SD) followup was 31.9 (9.9 months). Survival analysis showed a significant effect of severe DWML on time to poor outcome (p – 0.04) with a median survival of 136 days in those with severe lesions and 315 days in those without.
Conclusions
Severe white matter change on MRI is associated with poor outcome in elderly patients with major depression.
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