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BMJ Case Reports 2012; doi:10.1136/bcr-2012-007156
  • Reminder of important clinical lesson

Pseudodementia caused by severe depression

  1. Edward Tobe
  1. Department of Psychiatry, Cooper Medical School of Rowan University, University of Medicine and Dentistry State of New Jersey/School of Osteopathic Medicine, Camden, New Jersey, USA
  1. Correspondence to Dr Edward Tobe, edward.tobe{at}comcast.net

Summary

The diagnosis of pseudodementia may be difficult in a patient with a history of major depressive disorder. Clinical case history. A 70-year-old man with a history of major depressive disorder, in remission for 3 years, presented with confusion, agitation and cognitive disorder. The differential diagnosis included depression with pseudodementia, drug-induced dementia or Alzheimer disease. Mild cognitive improvement was noted after discontinuation of simvastatin. After 9 months of treatment for depression, the patient had remission that was sustained for >1 year, with mild residual difficulty remembering words of songs. The differential diagnosis of dementia includes major depressive disorder and adverse events from simvastatin.

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