The Question of Symptom Persistence

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Some have suggested that many depressive symptoms are largely transient, mild, shallower, or self-limited in patients with dementia (Devanand et al., 1997; Katz, 1998). O'Connor, Pollitt, and Roth (1990) and Forsell, Jorm, and Winblad (1994) found remissions of depression in all of their subjects with depression in dementia at baseline. However, other studies have found evidence for the persistence of depressive symptoms/syndromes. Janzing, Teunisse, and Bouwens (2000) reported that both syndromal and subsyn-dromal depression were highly persistent in nursing home residents with dementia, few of whom were treated with antidepressants. Another study demonstrated a recurrence rate of 85% for depressive symptoms in dementia (Levy et al., 1996). In terms of major depression, there is evidence for a chronic course of depression in dementia, with one study reporting that 58% of subjects with major depression in dementia still had depression at 16-month follow-up (Starkstein et al., 1997).

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