The spectrum of depressive pseudo-dementia
Depressive disorder causes cognitive symptoms. In the case of severe cognitive symptoms or when psychometric procedures measure cognitive decline in the range of dementia, depressed patients may be diagnosed as Depressive Pseudo-Dementia (DPD). There is no data that depressive disorder can cause dementia without coexisting depressive symptoms. The latter symptoms are frequently overseen because cognitive symptoms are equated with organic brain disease. There are typical neuropsychological features of cognitive decline in depressive disorders, like psychomotor retardation and the slow-start phenomenon.
Most patients referred to as DPD, suffer from depression-induced cognitive symptoms outside the range of dementia, but complain of memory disturbance and inability to think or concentrate. The diagnosis of DPD draws attention to a problem in the diagnosis of psychiatric disorders in the elderly: Old people suffering from depression are at particular risk of beeing labelled as demented. The most important step to diagnose depression causing dementia is the search for signs and symtoms of affective disorder even after having found cognitive symptoms.
KeywordsDepressive Symptom Depressive Disorder Depressed Patient Cognitive Symptom Psychomotor Retardation
Unable to display preview. Download preview PDF.
- American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. APA, Washington DCGoogle Scholar
- American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. APA, Washington DCGoogle Scholar
- Blau E, Ober BA (1988) The effect of depression on verbal memory in older adults. J Clin Exp Neuropsychol 10: 81Google Scholar
- Bleuler E (1916) Lehrbuch der Psychiatrie. Springer, BerlinGoogle Scholar
- Förstl H (1991) Das Demenzsyndrom der Depression. Neuropsychiatrie 5: 23–25Google Scholar
- Good MI (1981) Pseudodementia and physical findings masking significant psychopathology. Am J Psychiatry 136: 811–814Google Scholar
- Huber W, Poeck K, Weninger D, Wilimes K (1982) Aachener Aphasie Test. Hogrefe, GöttingenGoogle Scholar
- Kiloh LG (1961) Pseudo-dementia. Acta Psychiatr Scand 37: 336–351Google Scholar
- Kraepelin E (1896) Lehrbuch der Psychiatrie. Barth, LeipzigGoogle Scholar
- Kral VA (1982) Depressive Pseudodemenz and senile Demenz vom Alzheimertyp. Nervenarzt 53: 284–286Google Scholar
- McAllister TW, Price TRP (1982) Severe depressive pseudodementia with and without dementia. Am J Psychiatry 139: 626–629Google Scholar
- Pinel P (1798) Nosographie philosophique. Salpêtrière, ParisGoogle Scholar
- Wells CE (1979) Pseudodementia. Am J Psychiatry 136: 895–900Google Scholar