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Jeffrey M. Schwartz, MD; Lewis R. Baxter, Jr, MD; John C. Mazziotta, MD, PhD; Michael E. Phelps, PhD
UCLA School of Medicine Los Angeles

JAMA. 1988;259(10):1499-1500.

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In Reply.

—An intriguing issue is raised by Dr Dilsaver and Mr Smeltzer in their inquiry concerning a possible relationship between depressive subtypes and neurobiological mechanisms of cognitive impairment. Unfortunately, there are few data addressing this question at present.

Dr Dilsaver and Mr Smeltzer cite the finding by Wolfe et al¹ of a quantitative similarity between bipolar depressed patients and patients with Huntington's disease with respect to degree of cognitive impairment. However, Wolfe et al also point out that, with respect to patterns of response bias (ie, tendency to commit false-positive or false-negative errors), unipolar depressed patients are qualitatively similar to patients with Huntington's disease, while bipolar patients resemble controls. Cummings² has recently noted that it is the "pattern of intellectual disturbances" that best differentiates patients with subcortical dementias from those with dementias involving preponderantly the cerebral cortex. By these criteria, it would seem that unipolar depressed patients . . . [Full Text PDF of this Article]

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