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At least 379 records · Page 21Linked to original sources
PubMed1994

[Depressive pseudodementia. Diagnostic importance of quantified EEG].

The accuracy of computerized EEG to discriminate depressive pseudodementia from dementia was evaluated in 12 inpatients with recent cognitive impairments (all with DSM III R diagnosis of dementia). EEG were performed during wash-out period, then all subjects underwent an ECT and/or antidepressant trial. After this trial, clinical improvement was significant for six patients, while the six others remained unimproved. According to these two groups, electrophysiological data were retrospectively compared. Discriminant stepwise analysis exhibited that the combination of two parameters: symmetry of occipital alpha power and frontal alpha/theta ratio, was able to discriminate future responders from non responders patients with a greater accuracy than clinical and classical EEG parameters.

Aged↗
PubMed1982

Clinical applications of the dexamethasone suppression test for endogenous depression.

The dexamethasone suppression test (DST) was developed from the neuroendocrine research strategy to provide indirect information about the integrity of the limbic system in patients with endogenous depression (ED). Abnormal test results occur in close temporal relationship to clinical episodes of ED, but not during the intervals between episodes. The neuroendocrine disinhibition revealed by the test is not a trait marker of individuals predisposed to develop ED. A standardized DST procedure has been established and can be applied in outpatient or inpatient routine clinical practice, with good sensitivity (50-65%) and high specificity (96%). The conditional probability principles of interpreting the test results are discussed and the effect of prevalence on the predictive value of the test results is emphasized. The DST should not be used as a screening test for all psychiatric patients but should be reserved for cases where clinical indications for its use are present. These indications include diagnostic confirmation of ED, monitoring the response to treatment, prediction of relapse or new episodes, and possibly prediction of suicide risk in patients with ED. The test may be especially useful in the diagnostic assessment of patients with difficult or confusing presentations of ED such as catatonia, depressive pseudodementia, depression in adolescents or children, "masked" depression, depression complicated by a personality disorder, and schizoaffective depression.

Aging↗
PubMed1983

Affective disorders in the elderly: diagnostic and research considerations.

Although depressive disorders in the elderly represent a major public health concern by virtue of their high cost in human suffering, disability, and potential suicide, they have not been studied extensively, and specific criteria for diagnostic classification and optimal treatment are lacking. It seems likely that many of the affective syndromes in the elderly like senile melancholia, manic depressive illness, pseudodementia, and masked depression belong to the group of endogenous depressions, and can be identified by a constellation of clinical symptoms (endogenous or endogenomorphic profile), abnormal dexamethasone suppression test (DST) (at least 50%), and positive response to treatment with antidepressant medication. The rest are depressions reactive to psychogenic or sociogenic factors frequently presenting agitation as a dominant symptom, and finally there is a group of organic depressions due to underlying organic brain change, (i.e. senile dementia). It is possible that careful psychometric and psychiatric evaluation based on the symptom pattern, DST, and response to treatment would reveal reliable differences between pseudodementia and mild dementia and distinguish endogenomorphic from non-endogenomorphic depressions, respectively. The validity of such an approach remains to be demonstrated. Biological research in this area has provided valuable findings and should be the aim for the 1980s.

Aged↗
PubMed1989

Predicting mortality in mixed depression and dementia using EEG sleep variables.

The authors report a study of electroencephalographic (EEG) sleep predictors of two-year mortality in 26 elderly patients with mixed symptoms of depression and cognitive impairment. Patients who had died by two-year follow-up were characterized by significantly longer rapid eye movement (REM) sleep latencies at baseline, less robust REM sleep rebound following all-night sleep deprivation, and baseline apnea-hypopnea indexes greater than 3. Logistic regression analysis using the apnea-hypopnea index value and REM latency correctly predicted 77% of survivors and non-survivors. Survival time following initial measurements was significantly correlated with REM sleep time (r = 0.78, p less than .02) and duration of first REM sleep period (r = 0.75, p less than .02). The authors speculate that changes in these predictor variables may indicate impairment in the cholinergic control of cognitive function, REM sleep, and respiratory function.

Aged↗
PubMed1985

Tourette syndrome, atypical pervasive developmental disorder and Ganser syndrome in a 15-year-old, visually impaired, mentally retarded boy.

This is a case report of a 15-year-old visually impaired, mentally retarded male who presents with symptoms consistent with Tourette Syndrome, a Syndrome of approximate answers (Ganser's Syndrome) and Atypical Pervasive Developmental Disorder. The authors feel that this follow-up on the case presented earlier by Parraga and Butterfield raises the possibility of a link between a number of the symptoms of adult schizophrenia, appearing in attenuated form in these two cases, and Tourette Syndrome.

Adolescent↗
PubMed1992

Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool.

A group of 1070 community-living persons aged 65 and over was assessed using the GMS-AGECAT package and other interviews at years 0 and 3. Year 3 interviewers were 'blind' to the findings at year 0, and the prevalence of organic disorders and depression was very similar in both years. According to the results at year 3, minimum and maximum prevalence figures for dementia at year 0 were 2.4% and 3.8% for moderate to severe and 0.4% and 2.4% for mild or early cases, with a best estimate of 3.5% and 0.8%, or 4.3% overall, divided into: senile, Alzheimer's type 3.3%; vascular 0.7%; and alcohol-related 0.3%. The overall incidence of dementia, clinically confirmed by six-year follow-up, was 9.2/1000 per year (Alzheimer type 6.3, vascular 1.9, alcohol related 1.0). Three years later, 72.0% of those with depressive psychosis and 62.3% of those with depressive neurosis were either dead or had some kind of psychiatric illness. Nearly 60% of milder depressive cases (7.2% of the total sample) had either died or developed a chronic mental illness. The outcome of depressive pseudodementias is equivocal so far. Findings at year 3 provide validation of AGECAT computer diagnosis against outcome; organic and depression diagnoses are seen to have important implications for prognosis.

Aged↗
PubMed1993

Ganser syndrome followed by major depressive episode.

A case of complete Ganser syndrome resolved after one week, but was immediately followed by a major depressive episode. The two disorders had a common cause, which is best encapsulated in a psychodynamic formulation.

Adult↗
PubMedDate not supplied

A second visually impaired, mentally retarded male with pervasive developmental disorder, Tourette disorder and Ganser's syndrome: diagnostic classification and treatment.

The authors report a second visually impaired, mentally retarded male who presents with symptoms consistent with atypical pervasive developmental disorder, Tourette disorder, and a syndrome of approximate answers (Ganser's syndrome). Both this case and an earlier reported case are significant in that they identify two children with strikingly similar long-standing symptoms and developmental histories. Since these findings may have broader relevance to children with multiple coexisting disorders, diagnostic and intervention strategies in this population are reviewed.

Adolescent↗
PubMed1987

The functional somatic symptom.

The functional somatic symptom is a disorder that is prevalent in diverse patient populations. It is a heterogeneous disorder composed of a number of separate but often overlapping psychiatric disorders. The consultation-liaison psychiatrist is often consulted by his or her physician colleagues for help in the diagnosis and treatment of this difficult group of patients. This requires an understanding of the different dynamic formulations available to explain these disorders and a treatment strategy that emphasizes a collaborative approach to the long-term management of these patients.

Conversion Disorder↗
PubMed1997

A classification scheme for paradoxical vocal cord motion.

Paradoxical vocal cord motion (PVCM) is characterized by the inappropriate adduction of the true vocal cords during inspiration. Multiple causes have been proposed for this group of disorders, which share the common finding of mobile vocal cords that adduct inappropriately during inspiration and cause stridor by approximation. Management of this group of disorders has been complicated by the lack of a classification scheme to include all types of PVCM. We propose that PVCM be classified according to its underlying etiology and recognize the following causes of the disorder: 1. brainstem compression; 2. cortical or upper motor neuron injury; 3. nuclear or lower motor neuron injury; 4. movement disorder; 5. gastroesophageal reflux; 6. factitious or malingering disorder; 7. somatization/conversion disorder. Case reports are presented to illustrate the characteristic features and diagnostic evaluation used in assessing patients with PVCM. Management varies depending on the cause of PVCM and entails speech therapy, pharmacologic therapy, behavioral modification, and/or surgical intervention. Recognition of the multiple causes of PVCM allows otolaryngologists to formulate well-directed diagnostic evaluation and treatment.

Adolescent↗
PubMed1981

Pseudodementia. Current concepts and future directions.

The literature describing pseudodementia was reviewed and a definition for this neuropsychiatric syndrome is formulated. It is defined as an intellectual impairment in patients with a primary psychiatric disorder, in which the features of intellectual abnormality resemble, at least in part, those of a neuropathologically induced cognitive deficit. This neuropsychological impairment is reversible, and there is no apparent primary neuropathological process that leads to the genesis of this disturbance. Data from published reports and preliminary findings presented here suggest that intellectual impairment of patients with pseudodementia resembles subcortical dementia in many of its features.

Adolescent↗
PubMed1989

Psychometric detection of fabricated symptoms of combat-related post-traumatic stress disorder: a systematic replication.

Vietnam veterans with post-traumatic stress disorder (n = 11) and two other groups of Vietnam veterans (n = 24) instructed to fabricate symptoms of post-traumatic stress disorder completed the MMPI. A discriminant function analysis that used scale F and the post-traumatic stress disorder subscale correctly classified 91% of the subjects. This systematic replication supports the utility of the MMPI as a component in evaluating the validity of self-reported symptoms of post-traumatic stress disorder in Vietnam veterans.

Adult↗