Depression or Dementia?Depression often presents with symptoms suggestive of suggestive of Decision making adjective Referring to a pattern by LM or imaging, that the interpreter associates with a particular–usually malignant lesion. See Aunt Millie approach, Defensive medicine. dementia, and depression may coexist co·ex·ist intr.v. co·ex·ist·ed, co·ex·ist·ing, co·ex·ists 1. To exist together, at the same time, or in the same place. 2. with dementia. It is essential to diagnose depression, for the selection of antidepressant antidepressant, any of a wide range of drugs used to treat psychic depression. They are given to elevate mood, counter suicidal thoughts, and increase the effectiveness of psychotherapy. therapy will result in a positive outcome. On the other hand, the administration of antidepressants Antidepressants Medications prescribed to relieve major depression. Classes of antidepressants include selective serotonin reuptake inhibitors (fluoxetine/Prozac, sertraline/Zoloft), tricyclics (amitriptyline/ Elavil), MAOIs (phenelzine/Nardil), and heterocyclics to a patient with dementia, but no depression, might worsen wors·en tr. & intr.v. wors·ened, wors·en·ing, wors·ens To make or become worse. worsen Verb to make or become worse worsening adjn the degree of cognitive impairment. The differentiation between dementia and depression can be perplexing per·plex tr.v. per·plexed, per·plex·ing, per·plex·es 1. To confuse or trouble with uncertainty or doubt. See Synonyms at puzzle. 2. To make confusedly intricate; complicate. and disconcerting dis·con·cert tr.v. dis·con·cert·ed, dis·con·cert·ing, dis·con·certs 1. To upset the self-possession of; ruffle. See Synonyms at embarrass. 2. to the clinician clinician /cli·ni·cian/ (kli-nish´in) an expert clinical physician and teacher. cli·ni·cian n. . Depressed patients frequently complain of memory difficulties, but when evaluated formally, little if any impairment is detected. Disturbance in functioning is the hallmark of dementia, whereas disturbance of affect is the hallmark of depression. Furthermore, in depression, physiological (vegetative vegetative /veg·e·ta·tive/ (vej?e-ta?tiv) 1. of, pertaining to, or characteristic of plants. 2. concerned with growth and nutrition, as opposed to reproduction. 3. ) signs and psychological concomitances are present. The former include sleep disturbances, diminished appetite, weight loss, decreased energy and libido libido (lĭbē`dō, –bī`–) [Lat.,=lust], psychoanalytic term used by Sigmund Freud to identify instinctive energy with the sex instinct. ; the latter include poor concentration, difficulty in making decisions, and feelings of hopelessness and despair. Depressed patients tend to exaggerate the degree of their cognitive dysfunction as well as emphasizing their disabilities, whereas demented demented - Yet another term of disgust used to describe a program. The connotation in this case is that the program works as designed, but the design is bad. Said, for example, of a program that generates large numbers of meaningless error messages, implying that it is on the brink patients utilize denial mechanisms to minimize their symptoms in an attempt to conceal their disabilities. Detailed history-taking from the patient as well as from significant others, along with a careful evaluation of mental status, physical examination, and pertinent laboratory tests are essential for an accurate diagnosis. The Table should serve as a useful guide for the clinician to better differentiate dementia from depression.
TABLE. Signs and Symptomsof Alzheimer's Disease and Depression
Alzheimer's Disease
Onset Vague, insidious, no clear cut
time frame. Several months
to years
Progression Relatively steady decline
Affect Bland, labile fluctuating from
laughter to tears, not
consistent or sustained.
Influenced easily by suggestion.
Environmentally responsive
Memory
Short term Impaired
Long term Unimpaired early in disease,
later confabulation and/or
perseveration is present.
Orientation Varying levels of state of
awareness as disease progresses.
May exhibit disorientation to
time and place
Insight Lacking, minimal appreciation
for illness particularly in
later stages
Judgment Consistently poor. Varying
degree of appropriateness.
Deterioration of social skills
and personal hygiene
Intellect Grossly impaired on testing
Psychotic Paranoid delusions are often seen.
symptoms
Neurological Global amnesia, anomia, aphasia, apraxia
signs
Test performance Good cooperation and effort.
Near miss responses. Little test
anxiety
Depression
Onset Clear, recent, rapid Onset
with episodic course
Progression Uneven, fluctuating
Affect Marked disturbance, feelings
of despair, hopelessness which
are pervasive and persistent. Not
influenced by suggestion
Memory
Short term Minimal impairment as determined
Long term by objective testing
Orientation Basically unaffected. If present
not dramatic
Insight Present
Judgment Maybe poor but dramatically
different from that
observed in dementia
Intellect May appear impaired but performs
well on testing
Psychotic Auditory hallucinations and delusions
symptoms may occur in psychotic depression
Neurological None present
signs
Test performance Poor cooperation and effort.
Variable achievement.
Considerable anxiety. "I
don't know" answers are typical
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