Pseudodementia

Pseudodementia

Pseudodementia is a label given to cognitive impairments resulting from affective disorders, most commonly anxiety and depression; the terms "dementia syndrome of depression" and "depression-related cognitive dysfunction" have also been used. The pattern of cognitive deficits in individuals with depression most closely resembles that seen in so-called subcortical dementia, with bradyphrenia, attentional and executive deficits. In addition there may be evident lack of effort and application, "don’t know" answers, approximate answers (Ganser phenomenon, vorbereiden), and evidence of mood disturbance (tearfulness). Memory loss for recent and distant events may be equally severe (cf. temporal gradient of memory loss in dementia, e.g., due to Alzheimer’s disease). A 22-item checklist to help differentiate pseudodementia from Alzheimer’s disease has been described, based on clinical history, behavior and mental status.
The recognition of pseudodementia is important since the deficits are often reversible with appropriate treatment with antidepressants. However, it should be borne in mind that depression is sometimes the presenting symptom of an underlying neurodegenerative dementing disorder, such as Alzheimer’s disease. Longitudinal assessment may be required to differentiate between these diagnostic possibilities.

References

Andrews C. Pseudodementia responding to antidepressant therapy.
Progress in Neurology and Psychiatry 2002; 6(1): 26
Kiloh L. Pseudodementia. Acta Psychiatrica Scandinavica 1961; 37: 336-351
Roose SP, Devanand DP. The interface between dementia and depres-sion. London: Martin Dunitz, 1999
Wells CE. Pseudodementia. American Journal of Psychiatry 1979; 136: 895-900

Cross References

Attention; Bradyphrenia; Dementia; Ganser phenomenon