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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases are presented to illustrate some of the issues that arise in the management of patients diagnosed as suffering from the dementia syndrome of depression (Pseudodementia). Case 1 illustrates the dilemma of relatively normal autopsy findings in the brain in a patient presenting with a history of depression and dementia. Case 2 deals with a patient successfully treated for depression 14 years after the diagnosis of presenile dementia. Issues raised include the problem of labelling and the Rip Van Winkle situation of unanticipated recovery 14 years after this diagnosis was made. A planned approach to the treatment of pseudodementia systematically exploring available treatment options is recommended.
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PMID:Intractable depression and pseudodementia: a report of two cases. 319 18

Pseudodementia as a common trait in elderly depressives presents a major problem in gerontopsychiatry, especially for the differential diagnosis between Old-Age Depression (OAD) and Dementia of the Alzheimer Type (DAT). The present polysomnographic study examined parameters of sleep continuity, sleep architecture, and REM sleep to differentiate DAT from OAD. The investigation was based on the theoretical framework of the cholinergic-aminergic imbalance model of depression, the cholinergic deficit hypothesis of Alzheimer's disease and the reciprocal interaction model of Non-REM/REM sleep regulation, according to which REM sleep parameters should have high discriminative value to differentiate OAD and DAT. We investigated 35 DAT patients, 39 OAD patients and 42 healthy controls for two consecutive nights in the sleep laboratory. The DAT patients were in relatively early/mild stages of the disease, the severity of depression in the OAD group was moderate to severe. Depressed patients showed characteristic 'depression-like' EEG sleep alterations, i.e. a lower sleep efficiency, a higher amount of nocturnal awakenings and decreased sleep stage 2. Sleep continuity and architecture in DAT was less disturbed. Nearly all REM sleep measures differentiated significantly between the diagnostic groups. OAD patients showed a shortened REM latency, increased REM density and a high rate of Sleep Onset REM periods (SOREM), whereas in DAT REM density was decreased in comparison to control subjects. REM latency in DAT was not prolonged as expected. To assess the discriminative power of REM sleep variables a series of discriminant analyses were conducted. Overall, 86% of patients were correctly classified, using REM density and REM latency measures. Our findings suggest that REM density as an indicator of phasic activity appears to be more sensitive as a biological marker for the differential diagnosis of OAD and DAT than REM latency. The results support the role of central cholinergic neurotransmission in REM sleep regulation and the pathogenesis of DAT and OAD.
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PMID:The value of REM sleep parameters in differentiating Alzheimer's disease from old-age depression and normal aging. 969 95

In the limits between dementia and depression we find a clinical entity in permanent controversy; Depressive Pseudodementia. Depressive pseudodementia is defended by some authors and criticised by others and set us in the diagnostic frontier palced between the cognitive and the affective, between neurology and psychiatry. The entity is not well delimited and reaches diagnostic relevance clinical, evolution and response aspects. In the present issue, we realize a reflection on the term depressive pseudodementia with a review of the scientific literature with special attention in clinical and diagnostic subjets. We conclude that depressive pseudodementia although considering diagnostic limitations is still a valid term in clinical practice, and it eases the approximation, diagnosis and treatment of patients with mixed symptoms of cognitive and depressive type.
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PMID:[Depressive pseudodementia: Diagnostic frontiers]. 1189 91

Elderly depressive patients complaining about cognitive symptoms are at particular risk of being labelled as demented. It is well documented that depressive disorders frequently cause mild cognitive deficits which manifest in psychometric procedures. A wide spectrum of potentially reversible cognitive deficits related to a depressive syndrome are summarized under the term of "Depressive Pseudodementia (DPD)". Most depressive patients who are referred to "DPD" suffer from cognitive dysfunctions outside the range of dementia. The clinical interface between depression and dementia is complex. There is some evidence that depression may be a risk factor for the expression of Alzheimer's disease in later life and that depression may occur as a prodrome for Alzheimer dementia. Moreover, depression often complicates the course of dementing disorders. However, there is no evidence that depressive disorders cause dementia without coexisting depressive symptoms. It is essential to search for depressive symptoms even after cognitive symptoms have been found.
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PMID:[Depressive pseudodementia]. 1192 73

Neurogenesis persistently occurs even in the adult dentate gyrus. Since most of the anti-depression therapies increase adult neurogenesis, suppressed neurogenesis has been proposed to be one of the candidate etiologies of depression. Here we show that Cerebrolysin, an anti-dementia drug that improves the activity of daily living of Alzheimer disease (AD) patients, can enhance neurogenesis and spatial learning of adult female rats. Regarding the anatomical importance of the dentate gyrus in AD pathogenesis and the frequent association of depressive symptoms in preclinical phase of AD, our finding suggests a possibility that AD involves suppressed neurogenesis causing the decreased activity of daily living. Pseudodementia might also involve suppressed neurogenesis but differ form AD since the neurodegenerative process in AD may be irreversible.
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PMID:[The dentate gyrus neurogenesis: a common therapeutic target for Alzheimer disease and senile depression?]. 1280 1