Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a ten year study, 10% of patients at a general hospital in-patient unit had unsolved diagnostic problems at the time of discharge from hospital. These 132 cases were designated 'uncertain' and were followed up. Eighty-three patients were ultimately diagnosed, and 300 consecutive in-patients discharged from the same unit with a definite diagnosis were also studied. The clinical features and diagnoses of the two groups were compared. Special features associated with uncertainty were: a presenting complaint of pain; apathy without apparent mental or physical cause; hallucinosis or major paranoid symptoms without other good evidence of psychosis. Age was found to be relevant; compared with patients receiving confident diagnoses, those with uncertain diagnosis due to depressive psychosis were more often younger, while those due to neurosis or personality disorder tended to be older. Atypical psychotic depression was the condition most commonly associated with diagnostic doubt.
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PMID:Diagnosis 'uncertain': a follow-up study. 59 87

A seventy-year-old woman, formerly healthy and active, gradually changed and withdrew from social contact. She was admitted to a psychogeriatric ward with depressive symptoms, delusions and change of personality. We treated the condition as a depressive psychosis, but with little success. She was mentally rigid, withdrawn, behaved inappropriately and did not cooperate in the treatment. After months of gradual worsening we suspected frontotemporal dementia. Cognitive testing showed abnormal scores in tasks of executive functions but no major memory or language problems. Computerised tomography was negative. Single photon emission tomography (SPECT) showed marked hypoperfusion especially in the frontal lobes and with the lowest function on the left side. The investigations thus supported the diagnosis. All medication was tapered and she moved to a dementia care unit in her community. The case illustrates some of the diagnostic challenges in psychogeriatric medicine. Early frontotemporal dementia may easily be mistaken for depression, especially when apathy and withdrawal is dominant (apathetic/pseudodepressive subtype) and not disinhibition and inappropriate behaviour (disinhibited subtype).
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PMID:[70-year-old woman with depressive symptoms and personality change]. 1643 13