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Psuedo Depressive Dementia.

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I have always wanted to find out

1) What are the diagnostic criteria of Pseudo depressive dementia?

2)How do you distinguish between Dementia & Pseudo Depressive dementia?

3) Incidence/Prevalance of Pseudo depressive dementia.

4)Management of Pseudo depressive dementia?

5) Finally, any interesting papers of recent publication or classic old publications that are of value re:- psuedo depressive dementia.

Thank You.

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J,

That is the whole point.

Pseudo depressive dementia is not a ICD or DSM category(to the best of my knowledge).

I have gone to www.library.nhs.uk & did a literature search on various search engines like Medline,Psychinfo,Cinahl & looked back dated versions of American Journal of Psychiatry, British Journal of Psychiatry,APT etc....... Cochrane does not have anything on management too!

I drew a blank.Dont get me wrong, a few abstracts on Medline but nothing substantive.

Hence the question, what is it?

There is a group of people who appear to have dementia like symptoms, of the Fronto-Temporal variety(mostly before the age of 65) who actually respond to antidepressants

I currently am dealing with such a patient.

A Professor in Old Age Psychiatry suggested the diagnosis & we are currently awaiting the opinion of a renowned professor in Neurology who has published papers & written text books etc......

There seems to a black hole between Dementia & depression

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Is it pseudo-depressive dementia, or are you meaning depressive pseudo-dementia? I.e. is this a dementing process presenting with depressive symptoms, or a depressive illness presenting with cognitive impairment?

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Chris,

Thats the problem ! we have a middle aged man with florid psychotic symptoms(positive) with hyper-orality & doing the most bizzarre things describable. we thought that there was something organic & investigated him with MRI,PET,EEG etc........... & found he had fronto temporal deficits. he has hypertension & I & an other doctor found him to have TIA like episodes.so we thought of vascular dementia.We then got a very experienced old age psychiatrist to review him & depressive psuedodementia has been suggested by him.

We are currently awaiting a review by Prof Neary from Manchester(neurologist) on the advise by the psychogeriatrician. hence I did a literature search & found zilch on the topic.

Thats why I asked this question.

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Hmmm. Interesting.... No, sorry I haven't a clue either! :)

Hope you'll let us know what turns up...

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Jeffrey cummngs gives a fairly good account of Psuedodementias in his neuropsychiatry book.

Dementia syndrome ass with psychiatric disorders have been called pseudodementias

causes of Pseudodementia include

Mood disorders - Depression and mania

Schizophrenia

Hysteria - Conversion and Ganser syndrome

Anxiety, OCD, Malingering.

Cummings goes on to describe each condition.

He also gives references on onset, characteristics and course.

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depressive psuedodementia has been suggested by him.

if it's depressive pseudo dementia that means depression presenting as dementia. which means treat as if he is depressed (ie antideps, ect if necessary) and see if his cognitive function improves.

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my humble understanding is this type of dementia is not real but pseudo.i.e. it is not organic like alzheimer's,vascular or lewy body dementia but due to cognitive disturbances in depression(similarly it can occur in mania,anxiety etc).

in depressive pseudo dementia the cognitive decline has a temporal relation with the depressive symptoms,generally they give 'don't know' answers and respond to antidepressant trearment.

please keep us posted on the developments... :)

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