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Case report: An atypical presentation of dementia with affective disorder

Year 2020, , 136 - 139, 30.06.2020
https://doi.org/10.19161/etd.756295

Abstract

Psychosis is a general psychiatric definition used in different psychiatric disorders with severe disruption in thought and perceptions. Patients with psychotic episodes may have hallucinations, delusional beliefs and disorientation. They may show changes in personality. Since onset of psychosis occurs rarely in old age, depression and dementia should be primarily considered especially in elderly patients presenting with hallucinations, delusional beliefs, personality changes and thought disorder. We present a case report of patient with dementia and late onset depression presenting with tactile hallucination. The aim of this case presentation is to focus on the hazards of symptom-based diagnosis and treatment that may cause misdiagnosis in elderly patients. An 85-year-old male patient was admitted to outpatient clinic with a complaint of tingling in his body and the feeling of insects crawling underneath your skin. After physical examination and comprehensive geriatric assessment, psychiatric consultant evaluated patient in Geriatric Medicine department. He was diagnosed with psychotic depression and dementia. Every patient should be examined for the cognitive impairment by the physician. It should also be considered that other psychiatric disorders may accompany by the dementia.

References

  • American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. Fifth ed. American Psychiatric Publishing, Arlington, 2013: 87-88.
  • Lincoln TM, Mobius C, Huber MT, Nagel M, Moritz S. Frequency and correlates of maladaptive responses to paranoid thoughts in patients with psychosis compared to a population sample. Cogn Neuropsychiatry 2014; 19 (6): 509-26.
  • Brendel RW, Stern TA. Psychotic symptoms in the elderly. Prim Care Companion J Clin Psychiatry 2005; 7 (5): 238-41.
  • Cort E, Meehan J, Reeves S, Howard R. Very Late–Onset Schizophrenia-Like Psychosis: A Clinical Update. Journal of psychosocial nursing and mental health services 2017; 56 (1): 37-47.
  • Palmer BW, Mcclure FS, Jeste DV. Schizophrenia in late life: findings challange traditional concepts. Harv Rev Psychiatry 2001; 9 (2): 51-8.
  • Jeste DW, Finkel SI. Psychosis of alzheimer’s disease and related dementias. Diagnostic criteria for a distinct syndrome. Am J Geriatr Psychiatry 2000; 8 (1): 29-34.
  • El Haj M, Roche J, Jardri R, Kapogiannis D, Gallouj K, Antoine P. Clinical and neurocognitive aspects of hallucinations in Alzheimer’s disease. Neurosci Biobehav Rev 2017; 83: 713–20.
  • Moritz, S, Goritz, AS, Gallinat J et al. Subjective competence breeds overconfidence in errors in psychosis. A hubris account of paranoia. J Behav Ther Exp Psychiatry 2015; 48: 118-24.
  • Rubin, R. Exploring the relationship between depression and dementia. Jama 2018; 320 (10): 961-2.

Olgu sunumu: Atipik özellikli demans ve duygulanım bozukluk birlikteliği

Year 2020, , 136 - 139, 30.06.2020
https://doi.org/10.19161/etd.756295

Abstract

Psikoz, düşünce ve algının ağır oranda bozulduğu zihin durumunu tanımlamakta kullanılan genel bir psikiyatri terimidir. Psikotik epizot geçiren hastalar halüsinasyonlar görebilirler, delüzyonel inançlar taşıyabilirler, kişilik değişiklikleri ve düşünce bozukluğu gösterebilirler. Psikozun ileri yaşta başlaması daha nadir görüldüğünden; özellikle halüsinasyon, delüzyonel inançlar, kişilik değişiklikleri ve düşünce bozukluğu ile başvuran ileri yaştaki kişilerde ayırıcı tanıda psikoz tanısının yanı sıra depresyon ve demans tanıları da düşünülmelidir. Bu vakada, taktil halüsinasyonla başvuran, depresyonun eşlik ettiği 85 yaşında demans hastası sunulmuştur. Vücutta karıncalanma ve sürekli pirelerin ısırdığını hissetme şikâyeti ile başvuran erkek hastaya, fizik ve psikiyatrik muayene ile kapsamlı geriatrik değerlendirme sonrası psikotik bulgulu depresyon ve demans tanısı konmuştur. Hekim tarafından ileri yaştaki her hasta demansiyel süreç açısından değerlendirilmeli ve demansiyel duruma başka psikiyatrik hastalıkların eşlik edebileceği göz önünde bulundurulmalıdır.

References

  • American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. Fifth ed. American Psychiatric Publishing, Arlington, 2013: 87-88.
  • Lincoln TM, Mobius C, Huber MT, Nagel M, Moritz S. Frequency and correlates of maladaptive responses to paranoid thoughts in patients with psychosis compared to a population sample. Cogn Neuropsychiatry 2014; 19 (6): 509-26.
  • Brendel RW, Stern TA. Psychotic symptoms in the elderly. Prim Care Companion J Clin Psychiatry 2005; 7 (5): 238-41.
  • Cort E, Meehan J, Reeves S, Howard R. Very Late–Onset Schizophrenia-Like Psychosis: A Clinical Update. Journal of psychosocial nursing and mental health services 2017; 56 (1): 37-47.
  • Palmer BW, Mcclure FS, Jeste DV. Schizophrenia in late life: findings challange traditional concepts. Harv Rev Psychiatry 2001; 9 (2): 51-8.
  • Jeste DW, Finkel SI. Psychosis of alzheimer’s disease and related dementias. Diagnostic criteria for a distinct syndrome. Am J Geriatr Psychiatry 2000; 8 (1): 29-34.
  • El Haj M, Roche J, Jardri R, Kapogiannis D, Gallouj K, Antoine P. Clinical and neurocognitive aspects of hallucinations in Alzheimer’s disease. Neurosci Biobehav Rev 2017; 83: 713–20.
  • Moritz, S, Goritz, AS, Gallinat J et al. Subjective competence breeds overconfidence in errors in psychosis. A hubris account of paranoia. J Behav Ther Exp Psychiatry 2015; 48: 118-24.
  • Rubin, R. Exploring the relationship between depression and dementia. Jama 2018; 320 (10): 961-2.
There are 9 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Case Reports
Authors

Fatma Özge Kayhan Koçak 0000-0002-6447-2352

Gülser Karakoç 0000-0003-0219-9853

Seval Ay 0000-0002-7555-2657

Bahattin Gökdemir 0000-0001-9748-6913

Sercan Şahutoğlu 0000-0002-9217-5945

Zeliha Fulden Saraç 0000-0001-9281-2492

Sevnaz Şahin 0000-0001-5457-901X

Selahattin Fehmi Akçiçek 0000-0003-2583-4709

Publication Date June 30, 2020
Submission Date July 5, 2019
Published in Issue Year 2020

Cite

Vancouver Kayhan Koçak FÖ, Karakoç G, Ay S, Gökdemir B, Şahutoğlu S, Saraç ZF, Şahin S, Akçiçek SF. Olgu sunumu: Atipik özellikli demans ve duygulanım bozukluk birlikteliği. ETD. 2020;59(2):136-9.

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