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10 Cards in this Set

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DDx for depression.

Psycho-social factor? (1)
DDx for depression.

Psychiatric factors? (3)
Schizophrenia: frequent co-morbidity
Schizoaffective disorder: involves episodes of
Bipolar disorder
DDx for depression.

Organic factors? (8)
1. stroke
2. hypothyroidism
3. MS
4. seasonal affective states
5. TBI
6. infectious disease
7. drug use (particularly alcohol)
8. dementia in the elderly
Depression and Dementia

What percentage of elderly with dementia have depression?

What happens to dementia vs. depression Dx over time with elderly?
20% of elderly with dementia feature depression

- 5-15% of initial diagnoses of dementia later
changed to depression (Feinberg & Goodman,

- Reverse less frequent: 2.6-3% of major depression later amended to dementia
What do families of individuals with DAT tend to do in terms of their other-report of depressive symptoms?
Families tend to over pathologize: DATs 13.9%
DSM-III depression, families give rate of 50%.
10-20% of the depressed elderly experience ________ ____________in addition to depressive symptoms.
10-20% of the depressed elderly experience
cognitive impairment in addition to depressive
Differential diagnosis: Elderly

Are somatic symptoms more or less useful in term of making a DDx in the elderly vs the young?
Somatic symptoms useful in young but less so in
elderly (less sleep, energy, sex etc)
Traditionally thought that “Pseudodementia”
quickly reverses with aggressive psychiatric
treatment (eg ECT).

Why is it not so clearly the case now? (2 points)
- Not so clear now; e.g. Alexopolous (1991) 60% of
depressive pseudodementia group went on to
develop primary dementia three years later

- Most investigators now believe that depression
and dementia co-exist (Jones & Reifler, 1994)
Affective illness and stroke:

What percentage of stroke survivors subsequently develop depression?
40% of patients.

Mania rarely seen.
What type of stroke (which area? is most likely to result in depression?
Left frontal stroke most likely to result in depression, the closer to the left frontal pole the more likely.