Depression is a disorder in which the person feels intense sadness such that it interferes with the functioning of the body. Depressive dementia with cognitive impairment is called Pseudodementia. In other words when a person shows signs of dementia which is caused by depression other than a disease like Alzheimer’s is called pseudodementia. When a person is impaired on the neuropsychological testing of the memory and concentration, then the person is said to be suffering from pseudodementia which shows dementia like symptoms. This disorder is reversible, thus it is also called ‘reversible cognitive disorder’. It was first discovered by psychiatrist Leslie Kiloh in 1961.
Pseudodementia and dementia share most of the symptoms like forgetfulness, poor concentration, lack of motivation and loss of interest. Its presence can also indicate other disorder like schizophrenia, Ganser syndrome, dissociative disorders, etc. A complete clinical finding is necessary to detect the condition in a person. A few findings that have been reported are that the patient’s answer to every question asked is ‘I don’t know’. Memory loss is inconsistent whether remote or recent. As it rapidly progresses the patient starts to complain about cognitive dysfunction and the general performance is also very inconsistent. Other symptoms may be social withdrawal, appetite and sleep disturbances which may also include all the other signs and symptoms of depression. They also report early signs of mood swings.
One of the main causes for pseudodementia is the aging process of the brains, which gives rise to chemical, psychological and neurochemical changes in the body leading to depression. There are different causes reported for the onset of pseudodementia. Stress, anxiety and depression are the main emotional problems that may trigger the problem. Toxic effects of certain drugs like sleep inducer, brain tumor or an infection in the brain, under activity of the thyroid gland are some of the other causes for pseudodementia.
As aforementioned this is a reversible disease that is if the underlining cause is treated the symptoms of pseudodementia also diminishes. But, treating this condition is not that simple, it requires complex and multiple treatment and flexible approach. Finding the right form of treatment is necessary and an important step which needs to be flexible as the effects of the treatment varies in every individuals. Anti depressants work well if the underlining cause is an emotional problem. It may or may not be accompanied by shock therapy, as it hugely depends on the response of the patient to the treatment.
For elderly patients this form of treatment is not recommended as they may not be able to tolerate it. Hence non-pharmacological ways are adapted. Brain exercise and education is an effective way, this activates the blood cells which in turn improves the network of neurons thus helping in increasing the cognitive performance. In most cases Psychotherapy, Cognitive behavioral therapy (CBT) or interpersonal therapy (IPT) along with the medication is used to cure the ailment.
There is no cure that works in every case, but there are many options that can successfully treat the condition and continuous monitoring of the symptoms over time is necessitated.