Comorbidity Between Recurrent Major Depressive Disorder and CADASIL: A Case Report With a Brief Review of Published Cases.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) may underlie mood disorders by directly affecting cerebral vascular function and neural networks, thereby contributing to or worsening mood symptoms. The co-occurrence of CADASIL and major depressive disorder (MDD) in clinical practice complicates both diagnosis and treatment. We report a case of a 42-year-old woman with an 11-year history of recurrent MDD who presented with atypical depressive symptoms that required hospital admission. Subsequent assessment during hospitalization revealed persistent headaches and abnormal findings on cranial MRI. Given her familial predisposition and previous genetic analysis, a diagnosis of CADASIL was established. After a 3-week course of psychiatric intervention, notable amelioration was observed in both affective and neurological manifestations. The patient demonstrated limited tolerance to psychotropic medications during the treatment. Timely intervention can improve prognosis; however, emotional symptoms may persist, requiring continuous monitoring and management. We also review previously reported CADASIL cases with psychiatric manifestations to provide context.