Pseudodemência depressiva: fenomenologia psicopatológica e disfunções cognitivas

Abstract

Depressed patients often present cognitive impairment, including the possibility of developing dementia - called Depressive Pseudodementia. Despite the seriousness of the disease, publications with case presentation and psychopathological discussion are scarce. Objectives: To describe demographic, clinical and cognitive aspects in a group of patients with depressive Pseudodementia, besides reporting possible associations between Pseudodementia and the observed clinical findings. To perform a review on the topic and discuss the relevance and validity of the diagnosis. Methods: This is a descriptive study composed of patients with Pseudodementia Depressiva treated in Goiás in the 2007-2017 period, presenting a discussion about the results and comparison with other studies through literature review. Multidimensional anamnesis was used for the collection of clinical history and pathological antecedents. The diagnosis of Depressive Pseudodementia was performed by Yousef pseudodementia scale (YPS); other psychiatric diagnoses were defined by the DSM-5 and the severity of depression by the Hamilton scale. The cognitive assessment was performed by the Mini-Mental State Examination, functional questionnaire of Pfeffer and Clinical Dementia Rating (CDR). Results: The sample consisted mainly of women (96.67%) with a history of cardiovascular disease (43.33%) and neurological signs (53.33%). Depression with melancholic features occurred in 56,66% of the cases and the diagnosis of Bipolar Mood Disorder occurred in 100% of the sample. The main cognitive dysfunctions found were inattention (100%) and short-term hypomnesia (93.33%) corroborating the findings of the literature related to cognitive impairment and depression. Conclusions: The demographic and clinical aspects associated with Depressive Pseudo-dementia were female, antecedent of cardiovascular disease and presence of neurological signs; the basic psychiatric diagnosis was Bipolar Mood Disorder and the dominant depressive phenotype was depression with melancholic characteristics; and the central cognitive impairment was attention and short-term memory.