Models of depressive pseudoamnestic disorder

Jongwoo Choi; Seonjoo Lee; Jeffrey N Motter; Hyun Kim; Howard Andrews; P Murali Doraiswamy; D P Devanand; Terry E Goldberg

doi:10.1002/trc2.12335

Models of depressive pseudoamnestic disorder

Alzheimers Dement (N Y). 2022 Dec 13;8(1):e12335. doi: 10.1002/trc2.12335. eCollection 2022.

Authors

Jongwoo Choi¹, Seonjoo Lee^{1

2

3}, Jeffrey N Motter⁴, Hyun Kim⁴, Howard Andrews^{2

3}, P Murali Doraiswamy⁵, D P Devanand⁴, Terry E Goldberg^{3

4

6}

Affiliations

¹ Division of Mental Health Data Science New York State Psychiatric Institute New York New York USA.
² Department of Biostatistics Mailman School of Public Health Columbia University New York New York USA.
³ Department of Psychiatry Columbia University Medical Center New York New York USA.
⁴ Division of Geriatric Psychiatry New York State Psychiatric Institute New York New York USA.
⁵ Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA.
⁶ Department of Anesthesiology Columbia University Medical Center New York New York USA.

Abstract

Objective: Little effort has been made in the past to validate depressive pseudodementia based on hypothesis-driven approaches. We extended this concept to individuals with amnestic Mild Cognitive Impairment and Major Depression, that is, pseudodepressive amnestic disorder. We tested two hypotheses consistent with the presentations and mechanisms associated with this potential syndrome: improvements in cognition would be significantly correlated with improvements in depression after treatment (Hypothesis 1), and if not confirmed, the presence of such an association could be identified once moderator variables were taken into account (Hypothesis 2).

Methods: Within a clinical trial, 61 individuals received open label serotonin reuptake inhibitor (citalopram or venlafaxine) treatment over a 16-week period. Selective Reminding Test and Hamilton Depression scale were conducted serially to measure change in memory and depression, respectively. Magnetic resonance imaging, other cognitive measures (Alzheimer's Disease Assessment Scale-Cognitive and speed of processing tests), and additional depression measure (Beck Depression Inventory [BDI]) were also administered.

Results: No significant associations between improvement in depression and improvement in cognition were observed. Sensitivity analyses with other cognitive measures, the BDI, and exclusion of possible "placebo" responders were negative as well. There were no significant moderation effects for baseline Hamilton Rating Scale for Depression as a measure of symptom severity or age. APOE ε4 genotype and white matter hyperintensity burden yielded counter-intuitive, albeit marginally significant results.

Conclusions: Negative findings cast doubt on the frequency of depressive pseudoamnestic disorder in older populations with documented depression and memory impairments.

Keywords: Clinical trial; depression; memory; mild cognitive impairment; pseudodementia.