Psychiatr. praxi. 2021;22(3):158-162 | DOI: 10.36290/psy.2021.033

Faces of pseudodementia

MUDr. Jana Zmeková¹, prof. MUDr. Ján Praško, CSc.^{1, 2, 3}, PhDr. Marie Ocisková, Ph.D.¹, PhDr. Michaela Holubová, Ph.D.^{4, 5}, Mgr. František Hodný¹, MUDr. Jakub Vaněk¹

¹ Klinika psychiatrie, Lékařská fakulta Univerzity Palackého v Olomouci, Fakultní nemocnice Olomouc

² Univerzita Konštantína Filozofa v Nitre, Fakulta sociálnych vied a zdravotnictva, Katedra psychologických vied, Slovenská republika

³ Katedra psychoterapie, IPVZ Praha

⁴ Krajská nemocnice Liberec, Centrum psychiatrie

⁵ Fakulta Přírodovědně‑humanitní a pedagogická, Katedra pedagogiky a psychologie, Technická univerzita v Liberci

Pseudodementia, as one of the subtypes of transient or reversible dementias, is a condition characterized by a significant transient reduction in cognition. The review article summarizes the available resources dealing with the psychopathology, etiology and etiopathogenesis of pseudodementia. The clinical significance of pseudodementia lies in its potential to create an "impression of a deeper cognitive deficit" than the actual state of cognitive performance functions. Patients do not have difficulty equipping individual knowledge in targeted questioning but fail to systematize it and connect it in context, leading to reduced cognitive variability or impaired judgment. In the literature, the concept of pseudodementia appears mainly in depressive disorders and dissociative disorders. The similarity of dementia and pseudodementia symptoms sometimes leads to misdiagnosis and thus the administration of drugs that do not work in depression. While cognition is in place in dementia, antidepressants, electroconvulsive therapy, or a combination thereof are the primary approach in depressive pseudodementia. Thus, effective antidepressant treatment for depression alone can significantly help distinguish between pseudodementia and dementia. In dissociative amnesia, memory loss usually dominates critical recent events. It is an episodic memory disorder that cannot recall specific events, not acquired skills or knowledge. The beginning and the end are sudden. It usually ends in full recovery. However, some patients do not remember after years. Ganser syndrome is characterized by regressive behaviour and "approximate responses." It occurs mainly in prisoners in pre-trial detention. Other dissociative symptoms usually accompany memory disorders. Pseudodementia syndrome can be evaluated prognostically in two alternatives - as a prodrome of typical dementia and a secondary consequence of another psychopathology or other pathophysiological process.

Keywords: pseudodementia, depressive disorder, dissociation.

Published: October 14, 2021  Show citation