Major depression and bipolar disorders in CADASIL: A study using the DSM-IV semi-structured interview

R. Valenti, F. Pescini, S. Antonini, G. Castellini, A. Poggesi, S. Bianchi, D. Inzitari, S. Pallanti, L. Pantoni

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Objective- Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebral microangiopathy characterized by migraine, cerebrovascular events, and cognitive impairment. Although recognized as a cardinal feature of the disease, psychiatric disturbances have rarely been the object of focused studies. We performed a structured evaluation of mood disorders in CADASIL. Materials and Methods- Twenty-three patients with CADASIL (five men and 18 women) were assessed by psychiatrists using the Structured Clinical Interview for the DSM-IV, clinician version. For the quantitative assessment of current mood disorder symptoms, the Hamilton Rating Scale for Depression (HRSD) and the Young Mania Rating Scale (YMRS) were used. Results- A lifetime depressive episode was recorded in 17/23 (73.9%) patients with CADASIL. Six (26.1%) patients with CADASIL reported a current depressive episode. A diagnosis of manic lifetime episode was made in 6 (26.1%) patients with CADASIL. The HRSD mean score in patients with current depression was 9.1±SD 8.1. The YMRS mean score was 14.2±SD 4.1 for manic CADASIL. Conclusion- This study confirms that mood disorders are frequent in CADASIL. The use of a structured psychiatric interview outlines a frequency of depression higher than that previously reported but also reveals a considerable frequency of bipolar disorders. If confirmed in larger series, these data suggest that a greater attention should be paid to the psychiatric aspects in CADASIL.

Original languageEnglish
Pages (from-to)390-395
Number of pages6
JournalActa Neurologica Scandinavica
Issue number6
StatePublished - Dec 2011
Externally publishedYes


  • Bipolar disorders
  • DSM-IV
  • Depression
  • Diagnosis
  • Mood disorders
  • Structured interview


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