Psychiatria pre prax 2/2006

DEPRESSIVE PSEUDODEMENTIA (DPD)

A differentiation of depressive pseudodementia (DPD) from real dementia presents a frequent diagnostic problem. Depression is accompanied by cognitive symptoms. Typical neuropsychiatry symptoms of cognitive deficit – psychomotor retardation, decreased appetite, changes of circadian rhythm and other problems (8). Most of patients with DPD suffers from depression-induced symptoms not related to dementia and actively complain of memory disturbance an inability of thinking or concentration (5). Rapid and correct diagnostic evaluation and a decision about suitable therapy are urgent in serious DPD with psychomotor deceleration or even stupor and life threatening complications (dehydration, decubital ulcers, pneumonia, deep venous thrombosis with pulmonary embolism etc.). There is a danger of self-mutilation or suicidal behaviour. In elderly patients suffering from depression there is a danger of being diagnosed as having dementia and treatment could be neglected. The author describes a term of depressive pseudodementia (DPD), its development in psychiatry approach, combination of depression and cognitive disorder (3, 4, 5, 10). He also presents a tool for clinical differentiation of DPDS from degenerative dementia (2, 10, 11) and treatment options.

Keywords: depressive pseudodementia, depressive dementia, depression in elderly.