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Similarities Between Depression and Neurodegenerative Diseases: Pathophysiology, Challenges in Diagnosis and Treatment Options

机译:抑郁症与神经变性疾病之间的相似性:病理生理学,诊断和治疗方面的挑战

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Depressive disorder and neurodegenerative diseases are two different clinical entities. Depression is a common psychiatric disorder in the general population. However, when present concomitantly with neurodegenerative disorders, its diagnosis becomes challenging. In many cases, patients remain undiagnosed and hence, untreated, worsening the prognosis of the neurodegenerative diseases and impairing the quality of life. One of the possible reasons for the difficulties in diagnosis in such cases is that both conditions affect the central nervous system, so there might be an overlap of symptoms leading to a missed diagnosis of depression in a neurodegenerative disease patient and vice versa. Symptoms such as irritability, apathy, and decreased cognition are common to both types of disorders. Some neurodegenerative diseases, especially Alzheimer's disease, can initially present as a depressive prodrome. This may cause a difficulty in differentiating between these two conditions and a diagnosis of either conditions may be missed; hence an opportunity for timely intervention and improved outcomes is missed. An approach towards analyzing and comparing the pathological mechanisms common to both disease types will create a better understanding of depression and neurodegenerative diseases, identify their similarities, and develop improved clinical criteria to help clinicians make a timely diagnosis of these conditions present together. In the present review, various studies related to common pathological links, concomitant diagnosis challenges, and ongoing research about different treatment options are discussed.
机译:抑郁症和神经变性疾病是两种不同的临床实体。抑郁症是一般人群中常见的精神疾病。然而,当伴随着神经退行性障碍的情况下,其诊断变得具有挑战性。在许多情况下,患者仍未诊断,因此不治疗,恶化神经退行性疾病的预后并损害生活质量。在这种情况下诊断困难的可能原因之一是,这两种条件都会影响中枢神经系统,因此症状可能会重叠,导致神经变性疾病患者抑郁症的错过诊断,反之亦然。症状如烦躁,冷漠和降低的认知对两种类型的疾病都是常见的。一些神经退行性疾病,特别是阿尔茨海默病,最初可以作为抑郁的前驱蛋白呈现。这可能导致难以区分这两个条件,并且可能错过任何一个条件的诊断;因此,错过了及时干预和改进结果的机会。分析和比较两种疾病类型共同的病理机制的方法将更好地了解抑郁和神经变性疾病,确定它们的相似性,并制定改进的临床标准,以帮助临床医生及时诊断这些条件在一起的情况。在本综述中,讨论了与常见病理联系,伴随诊断挑战以及对不同治疗方案的持续研究有关的各种研究。

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