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Schizophrenia Case Study: Residual Thought Disorder versus Emerging Dementia

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Physician's Field Guide to Neuropsychology

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Abstract

This chapter describes the challenging differential diagnosis of cognitive impairment in a patient with a severe psychiatric disorder. An older adult with a long history of a schizophrenia-spectrum disorder presented with exacerbation of psychotic symptoms, aggression, and cognitive concerns. The patient and his psychiatrist wondered about the source of the cognitive deficits and how this would affect his treatment options and prognosis. In addition to a long-standing serious mental illness, this patient had a number of possible medical conditions associated with cognitive decline and was also taking medications that affect cognition. The patient was referred for neuropsychological assessment. The neuropsychologist worked collaboratively with the psychiatrist and patient to discern whether the cognitive changes were related to schizophrenia, incipient dementia, or medication effects. Input from neuropsychology aided in treatment planning.

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Author information

Authors and Affiliations

  1. Department of Graduate Psychology, James Madison University, Harrisonburg, VA, USA

    Bernice A. Marcopulos

  2. Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health Sciences Center, Charlottesville, VA, USA

    Bernice A. Marcopulos & Robert Gardella

  3. Western State Hospital, Staunton, VA, USA

    Robert Gardella

Authors
  1. Bernice A. Marcopulos
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  2. Robert Gardella
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Corresponding author

Correspondence to Bernice A. Marcopulos .

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA

    Karen M. Sanders

Chapter Review Questions

Chapter Review Questions

  1. 1.

    How does thought disorder differ from the cognitive changes seen in early dementia?

  2. 2.

    What is the relative risk of Alzheimer’s disease in persons with schizophrenia?

  3. 3.

    What is the mechanism for cognitive impairment with anticholinergics?

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Marcopulos, B.A., Gardella, R. (2019). Schizophrenia Case Study: Residual Thought Disorder versus Emerging Dementia. In: Sanders, K. (eds) Physician's Field Guide to Neuropsychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-8722-1_24

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  • DOI: https://doi.org/10.1007/978-1-4939-8722-1_24

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-8720-7

  • Online ISBN: 978-1-4939-8722-1

  • eBook Packages: MedicineMedicine (R0)

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