A preliminary report: a new scale to identify the pseudodementia syndrome

✍ Scribed by George Yousef; William J. Ryan; Tim Lambert; Brice Pitt; John Kellett

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 134 KB
• Volume: 13
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/(sici)1099-1166(199806)13:6<389::aid-gps782>3.0.co;2-c

✦ Synopsis

Background. The literature was reviewed to abstract items which were claimed to distinguish organic dementia from pseudodementia. Their discriminating powers were tested in a prospective study. Eighteen of these items were selected to create a questionnaire which should distinguish organic dementia from pseudodementia. The gold standard was the ®nal diagnosis given by a consultant psychiatrist 12±14 months later.

Method. One hundred and twenty-eight patients referred to our service with a dierential diagnosis of depressive pseudodementia were screened using a checklist of 44 characteristic features (in the form of questions with yes' or no' answers) which were claimed in the literature to dierentiate between organic dementia and depressive pseudodementia. This checklist covers the areas of history, clinical data, insight and performance.

Results. Forty points (questions) out of the 44 in the checklist showed signi®cant discriminating power to dierentiate dementia from depressive pseudodementia (p 5 0.01). A principal component and factor analysis was performed from which 18 questions were extracted. The shortened questionnaire was able to classify (43/44 cases) 98% of dementia cases and (60/63) 95% of depression correctly. A new de®nition has been introduced for `pseudodementia' as a syndrome of reversible subjective or objective cognitive problems caused by non-organic disorder. Thus depressive pseudodementia may be classi®ed into two subtypes. Type I is a group of patients who have depressive symptoms with subject complaint of dysmnesia without measurable intellectual de®cits. Type II is a group of patients who have depressive symptoms and show poor cognitive performance based on poor concentration not due to organic disorder.