Depression is a common comorbidity in dementia. Randomised controlled studies of antidepressants do not show a significant improvement in depressive symptoms in patients with comorbid dementia and are known to lead to an increase in side effects. However, there are relatively few studies of depression in dementia, and drawing firm conclusions about the use of antidepressants is limited by the amount of data available. Furthermore, it is unclear whether data can be extrapolated from similar populations (eg, those with late-life depression) to inform pharmacotherapy in this patient group. Given the lack of effectiveness and risk of side effects associated with pharmacological treatments, psychological interventions may offer important therapeutic benefits. There is evidence for the effectiveness of individual psychological therapy, and further research will establish which psychological approach is the most effective. Some studies have shown an improvement in depressive symptoms using structured sleep hygiene programmes, exercise, arts interventions and music therapy. These studies are hampered by small data sets, and the benefits to individuals may not be well captured by standard outcome measures. At present, the best evidence for arts-based approaches is in music therapy. Depression with comorbid dementia responds well to electroconvulsive therapy and this is a useful treatment modality for those with severe or life-threatening depressive symptoms. Alternative neurostimulation techniques such as transcranial magnetic stimulation are not widely used at present and further research is needed before they can be a more widely used treatment modality.

中文翻译：

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治疗抑郁症合并痴呆症。

抑郁症是痴呆症的常见合并症。抗抑郁药的随机对照研究并未显示出共病痴呆患者的抑郁症状有显着改善，并且已知会导致副作用增加。然而，关于痴呆症中抑郁症的研究相对较少，并且关于抗抑郁药的使用得出确切的结论受到可用数据量的限制。此外，尚不清楚是否可以从类似人群（例如患有晚年抑郁症的人群）推断数据来为该患者组的药物治疗提供信息。鉴于药物治疗缺乏有效性且存在副作用风险，心理干预可能会提供重要的治疗益处。有证据表明个体心理治疗的有效性，进一步的研究将确定哪种心理治疗方法最有效。一些研究表明，通过结构化睡眠卫生计划、锻炼、艺术干预和音乐疗法可以改善抑郁症状。这些研究受到小数据集的阻碍，并且标准结果衡量标准可能无法很好地体现对个人的好处。目前，基于艺术的方法的最佳证据是音乐治疗。伴有痴呆的抑郁症对电休克治疗反应良好，对于患有严重或危及生命的抑郁症状的患者来说，这是一种有用的治疗方式。经颅磁刺激等替代神经刺激技术目前尚未广泛使用，需要进一步研究才能成为更广泛使用的治疗方式。