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2 results

  • They are not real patients

  • T. Jiménez Aparicio, C. De Andrés Lobo, C. Vallecillo Adame, M. Queipo De Llano De La Viuda, G. Guerra Valera, A. Gonzaga Ramírez, J. Gonçalves Cerejeira, I. Santos Carrasco, C. Capella Meseguer, E. Rodríguez Vázquez
  • Journal:
    European Psychiatry / Volume 64 / Issue S1 / April 2021
    Published online by Cambridge University Press:
    13 August 2021, p. S688
    • Article
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  • Introduction

    Cognitive depressive disorder (or depressive pseudodementia) is a condition defined by functional impairment, similar to dementias or other neurodegenerative disorders, in the context of psychiatric patients. It is important to consider a differential diagnosis in patients with cognitive impairment.

    Objectives

    Presentation of a clinical case of a patient with depression with psychotic symptoms who presents cognitive impairment.

    Methods

    Bibliographic review of the differential diagnosis between cognitive depressive disorder and real dementia by searching for articles in PubMed.

    Results

    We present a 51-year-old woman, previously diagnosed with adjustment disorder (with mixed anxiety and depressed mood) and unspecific anxiety disorder, who was admitted to the hospital due to delusional ideation of harm and Capgras syndrome, ensuring that her relatives had been replaced and the rest of the patients were not real patients, but actors who conspired against her. The MRI (Magnetic Resonance Imaging) was strictly normal (tumors or acute injuries as stroke or hemorrhage were discarded), and a MoCA (Montreal Cognitive Assesment) test was performed to screen any cognitive impairments (obtaining a score of 19/30, with language fluency and abstraction particularly affected). It would be convenient to repeat the test when this episode and the psychotic symptoms are resolved or improved.

    Conclusions

    1. Some patients may have cognitive impairment in the context of a mood disorder. 2. A differential diagnosis and follow-up of these patients should be performed to assess prognosis, reversibility and treatment. 3. Depressive cognitive impairment may precede the development and establishment of a dementia or neurodegenerative picture.

    Disclosure

    No significant relationships.

  • 12 - Depressive pseudodementia

  • from Part II
  • Edited by German E. Berrios, University of Cambridge, John R. Hodges, University of Cambridge
  • Book:
    Memory Disorders in Psychiatric Practice
    Published online:
    06 January 2010
    Print publication:
    16 March 2000, pp 268-290

  • Summary

    The memory lapses often recorded in elderly depressed patients with depressive pseudodementia reflect true cognitive difficulties. Sometimes associated with soft signs, and sometimes contrasted with cognitive impediments seen in patients whose 'subcortical' disease (e.g. progressive supranuclear palsy) primarily affects frontostriatal systems,this reversible dementia is thought to compromise memory primarily by disrupting accessory behaviours (e.g. attention) that are necessary to engage/maintain mnestic activity. Directly relevant to the question of pseudodementia is the research seeking to plot normal cognitive ageing in terms of functional competence, neuropsychological performance, neuroradiological correlates, etc. and how 'non-harbiger' conditions of age-related cognitive decline (DSM4) or age-associated memory impairment (AAMI) differ from dementia. It is still unclear how profiles on cognitive diagnostics can be shown to reliably distinguish between reversible and irreversible patients, and whether such profiles can be used to avoid misclassifying other depressed patients in preclinical stages of Alzheimer's disease (AD).