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Showing papers on "Depression (differential diagnoses) published in 1981"



Journal ArticleDOI
TL;DR: The results confirm the high incidence of depression in PD and suggest that depression in Parkinson patients may be accompanied by mild intellectual impairment and inattention which is independent of the severity of the illness.
Abstract: To determine the prevalence of depression in Parkinson disease (PD) we evaluated 55 consecutive patients without dementia and 31 of their spouses. All subjects completed the Beck depression inventory and a quantitative mini-mental state examination. Using the Beck criteria, 47% of the patients and 12% of the spouses rated themselves as significantly depressed. Mental state scores were significantly lower in the patients. There was a correlation between the severity of depression and cognitive impairment, particularly for calculation, digit span, and visuomotor skills. The severity of parkinsonism, particularly bradykinesia, also paralleled cognition. There was a slight but significant relationship between parkinsonism and depression. These results confirm the high incidence of depression in PD, and suggest that depression in Parkinson patients may be accompanied by mild intellectual impairment and inattention which is independent of the severity of the illness.

598 citations


Journal ArticleDOI
TL;DR: An extensive study which compares cognitive therapy, antidepressant drugs and a combination of these two, in depressed patients seen either in general practice or an out-patient department and results are discussed in terms of Beck's cognitive theory of depression.
Abstract: We report an extensive study which compares cognitive therapy, antidepressant drugs and a combination of these two, in depressed patients seen either in general practice or an out-patient department. One-hundred and forty patients were screened for primary major depression and 64 patients completed the trial. All were rated on seven measures of mood, including independent observer-rated and self-rated depression and scales of anxiety and irritability. Patients were randomly assigned to cognitive therapy, antidepressants or a combination of the two. The antidepressant drug group did less well in both hospital and general practice and combination treatment was superior to drug treatment in both hospital and general practice. In general practice, cognitive therapy was superior to drug treatment. The presence of endogenous features did not affect response to treatment. The results are discussed in terms of Beck's cognitive theory of depression and factors of presumed causal importance of depression in general practice.

491 citations


Journal ArticleDOI
TL;DR: The occurrence of depression was determined during the summer of 1979 in a multi-ethnic probability sample of 1003 adults in Los Angeles County, as part of a community survey of the epidemiology of depression and help-seeking behavior.
Abstract: The occurrence of depression was determined during the summer of 1979 in a multi-ethnic probability sample of 1003 adults (66% participation) in Los Angeles County, as part of a community survey of the epidemiology of depression and help-seeking behavior. The primary measure of depression was the 20-item CES-D scale developed by the Center for Epidemiologic Studies. The overall prevalence of depression based on a CES-D cutpoint definition of 16 or greater was 19.1%. The prevalence of depression was greatest among Hispanics (27.4%) and least among whites (15.6%), with blacks and others at an intermediate level (21.8% and 21.2%, respectively). Females (23.5%) were nearly twice as likely to be depressed as males (12.9%). By age, persons 18-24 years reported the highest rate of depression (27.4%), while those 45-64 years reported the lowest (16.3%). As expected, the prevalence of depression was strongly related to family income, with the highest level reported for those earning less than $8500 (29.3%); the lowest level for those earning more than $25,000 (9.0%). After controlling for effects of selected demographic and socioeconomic variables, neither race nor ethnicity were significantly related to the presence of depression. This suggests that the economic strain experienced by many minorities may be an important determinant of higher rates of depression among blacks and Hispanics.

446 citations


Journal ArticleDOI
TL;DR: Depression following left hemispheric brain injury may not be a nonspecific neurological or psychological response, but rather may be a symptom of injury to specific pathways, such as the catecholamine‐containing ones, as they pass through the frontal cortex.
Abstract: Eighteen patients with left hemispheric strokes were compared to 11 patients with traumatic brain injury for frequency and severity of depression, using several mood scales. More than 60% of the stroke patients had clinically significant depressions as compared with about 20% of the trauma patients, even though the two groups had comparable impairments in their activities of daily living and global cognitive functions. Analyses of brain CT scans revealed that the two groups had similar-sized lesions, but the areas of ischemic injury were more anterior than the traumatic lesions. When the results were controlled for lesion location, there were no significant differences in mood between the two groups. The severity of depression was directly correlated with the closeness of the lesion to the frontal pole. These results suggest that depression following left hemispheric brain injury may not be a nonspecific neurological or psychological response, but rather may be a symptom of injury to specific pathways, such as the catecholamine-containing ones, as they pass through the frontal cortex.

435 citations


Journal ArticleDOI
TL;DR: A one-year naturalistic follow-up of the 35 subjects who completed the protocol revealed that although many of the patients had a variable clinical course, both original treatment groups remained generally well and none of the between-group differences were significant.
Abstract: Using a controlled, clinical-trial format, 44 nonpsychotic, nonbipolar, depressed outpatients were treated with cognitive therapy or imipramine hydrochloride over a 12-week period. Although both interventions were associated with significant reductions in levels of depression, the cognitive-therapy patients showed greater symptomatic improvement and a higher treatment-completion rate. A one-year naturalistic follow-up of the 35 subjects who completed the protocol revealed that although many of the patients had a variable clinical course, both original treatment groups remained generally well. Self-rated depressive symptomatology was significantly lower for those who, one year earlier, had completed cognitive therapy than for those who had been in the clinical trial's pharmacotherapy cell. While there were several other interesting trends in favor of the cognitive-therapy patients, none of the between-group differences were significant. The pragmatic and clinical implications of the followup results are discussed.

337 citations


Journal ArticleDOI
TL;DR: Life events reported to have occurred 6 months before the onset of illness were compared in 40 outpatients who had a first episode of primary depression and a matched normal control group, consistent with the view that certain recent life events play a substantial role as precipitants in some depressed patients.

336 citations


Journal ArticleDOI
TL;DR: Psychological depression was associated with a twofold increase in odds of death from cancer during 17 years of follow‐up, and persisted after adjustment for age, cigarette smoking, use of alcohol, family history of cancer, and occupational status, and was apparently not specific to any particular site or type of cancer.
Abstract: Psychological depression, measured in 1957-1958 by the Minnesota Multiphasic Personality Inventory at the baseline examination of 2,020 middle-aged employed men, was associated (p less than 0.001) with a twofold increase in odds of death from cancer during 17 years of follow-up. The association did not vary appreciably in magnitude among the early (1958-1962), middle (1963-1968), and later (1969-1974) years of follow-up, persisted after adjustment for age, cigarette smoking, use of alcohol, family history of cancer, and occupational status, and was apparently not specific to any particular site or type of cancer. This result, predicted in advance on the basis of findings by other investigators, is consistent with the hypothesis that psychological depression is related to impairment of mechanisms for preventing the establishment and spread of malignant cells.

310 citations


Journal ArticleDOI
TL;DR: Based on five case studies, several clinical guidelines for recognizing and diagnosing depression in brain-damaged patients are offered and initial hypotheses about the neuroanatomical basis of the depressive syndrome are generated.
Abstract: • Recognizing depression in brain-damaged patients poses considerable problems. The standard dignostic criteria often are not applicable since the neurological lesion may distort or even obliterate salient features of depression. Patients actually may deny being depressed or dysphoric, not have a depressive affect, or be totally unaware of abnormal vegetative behaviors. Furthermore, brain lesions themselves may produce striking behavioral alterations that can be mistakenly attributed to depression, or striking behavioral changes due to depression may be mistakenly attributed to the brain lesion. Based on five case studies, several clinical guidelines for recognizing and diagnosing depression in brain-damaged patients are offered. These cases also provide a data base to generate initial hypotheses about the neuroanatomical basis of the depressive syndrome. By observing how focal brain lesions modify the signs and symptoms of depression, inferences are made about brain areas crucial for modulating the various features of the depressive syndrome.

245 citations


Journal ArticleDOI
TL;DR: During infusion of PGE1, arterial blood pressure and respiratory activity should be monitored carefully and appropriate supportive steps taken if hypotension or respiratory depression occurs, and the development of fever or jitteriness may require reduction of the infusion rate.
Abstract: The case reports of 492 infants with critical congenital cardiac disease treated with prostaglandin E1 (PGE1) were reviewed to determine the nature and incidence of intercurrent medical events. Forty-three percent of the infants had at least one such event, but only half of these were related to PGE1 and the majority required only minor changes in management. Cardiovascular events were the most common (18% incidence), with cutaneous vasodilation and edema occurring more frequently during intraaortic infusion than during i.v. infusion. Central nervous system events were reported in 16% of the patients. Respiratory depression was reported in 12%, and was particularly common in infants weighing less than 2.0 kg at birth (42%). Hematologic, infectious and renal events appeared for the most part to be unrelated to PGE1. The overall mortality (excluding 19 patients with hypoplastic left-heart syndrome) was 31%; the mortality for the patients with critical coarctation or interruption of the aortic arch was nearly twice that for the cyanotic infants (50% vs 27%). No death was attributed to PGE1 administration. During infusion of PGE1, arterial blood pressure and respiratory activity should be monitored carefully and appropriate supportive steps taken if hypotension or respiratory depression occurs. The development of fever or jitteriness may require reduction of the infusion rate and, in view of the possible increased incidence of infections, the prophylactic use of antibiotics is recommended.

229 citations


Journal ArticleDOI
TL;DR: Depression assessed by clinical examination and Hamilton rating scale was found in half of untreated new acute schizophrenics and in about a third of chronic schizophrenics who relapsed whether treated with depot injections or not, suggesting that drugs can play a part.
Abstract: Depression assessed by clinical examination and Hamilton rating scale was found in half of 37 untreated new acute schizophrenics, and in about a third of chronic schizophrenics who relapsed whether treated with depot injections (89) or not (79). A significant part of depressive illness in schizophrenics is thus not drug-related. However, depression was commoner in those on higher doses of depot neuroleptic (P <.05) or who showed extrapyramidal side effects (P <.001), suggesting that drugs can play a part. Patients maintained in remission on moderate doses of depot drug had the lowest prevalence of depression.

Journal ArticleDOI
TL;DR: Data for schizophrenic patients in prospective studies and a comparison group of depressives show that depressive symptoms are more prevalent during the acute phase of the illness and they decrease (rather than increase) in severity with effective neuroleptic treatment.
Abstract: • Symptoms of depression are common in patients who have been treated for schizophrenia. Various concepts have been proposed to explain the relationship between depression and schizophrenia. Data for schizophrenic patients in prospective studies and a comparison group of depressives show that depressive symptoms are more prevalent during the acute phase of the illness and that they decrease (rather than increase) in severity with effective neuroleptic treatment.

Journal ArticleDOI
TL;DR: The frequency with which antidepressants can significantly alleviate pain associated with depression highlights the importance of the link between pain and depression, which may be partially explained by the close relationship of enkephalins and biogenic amines.

Journal ArticleDOI
07 Aug 1981-JAMA
TL;DR: Alcohol abuse appears to be a risk factor in adverse fetal outcome, and excessive consumption has been implicated in impotency and early onset of postmenopausal amenorrhea.
Abstract: Ethanol is a drug that is classified as a general CNS depressant. Long-term exposure can result in tolerance and physical dependence. Ethanol consumption can affect the pharmacologic and therapeutic actions of prescription drugs, over-the-counter drugs, and illicit drugs. Ethanol-drug interactions have been reported to be the most frequent cause of drug-related medical crises in the United States. Alcohol misuse has a pervasive and potentially detrimental effect on the body from its point of entry through the gastrointestinal tract, to related organs such as the liver and the pancreas. The liver is one of the organs most significantly damaged and physiologically deranged as a result of alcohol ingestion. The two most common hepatic complications of alcoholism are hepatitis and cirrhosis. Cirrhosis was the seventh most common cause of death in the United States in 1975. Alcohol abuse interacts with physiological and metabolic processes of digestion to contribute to nutrient deficiency. Alcohol abuse has been suggested as the most common cause of vitamin and trace element deficiency in adults in the United States. Alcohol-derived nutritional deficiencies result in suboptimal health and are contributory to such abnormalities as anemia, convulsions, small-bowel dysfunction, and overt disorders such as Wernicke's encephalopathy. Brain dysfunction has been estimated to be present in from 50% to 70% of detoxified alcoholics entering treatment. Abstracting and adaptive abilities of social drinkers who had consumed no alcohol for 24 hours at the time of testing were found to be negatively associated with the amount of alcohol normally consumed per drinking occasion. Alcohol consumption alters numerous functions of the endocrine system, and excessive consumption has been implicated in impotency and early onset of postmenopausal amenorrhea. Recent evidence suggests that alcoholism may be a multifactorial genetically influenced disorder. In addition to genetics, social and environmental influences play significant roles. There is an association between alcoholism and depression in both men and women. Alcoholics often have high levels of depression and alcohol itself can increase depression. A disproportionately high number of people with drinking problems commit suicide, and more than a third of suicides involve alcohol. A propensity for suicide is thought to be associated with certain alcohol-related conditions such as depression, anxiety, mood fluctuations, and deteriorated social integration. Alcoholism has been associated with a number of adverse effects on the cardiovascular system, including a specific cardiomyopathy, low mean cardiac output, and depressed myocardial contractility. The drinking of large amounts of alcohol is associated with significant increases in blood pressure. Noncardiac myopathy has also been related to alcohol consumption. Heavy drinking increases the risk of cancer developing in the tongue, mouth, oropharynx, hypopharynx, esophagus, larynx, and liver. In the United States, these sites represent 6.1% to 9.1% of all cancer in the white population and 11.3% to 12.5% in the black population. In the broadest scope, alcohol abuse appears to be a risk factor in adverse fetal outcome. Fetal alcohol syndrome (FAS) has been identified among some children of alcoholic women. Fetal alcohol syndrome is characterized by CNS dysfunction, growth deficiency, a specific cluster of facial abnormalities, and other malformations, particularly skeletal, urogenital, and cardiac. It has been suggested that FAS is one of the leading causes of birth defects associated with mental retardetion. Short of the full complement of defects that characterize FAS, heavy alcohol use by women has been associated with birth anomalies. These effects of alcohol are independent of likely confounding variables, including smoking. Decreased birth weight is frequently associated with increased neonatal risk and has been observed among the children of women who consume an average of 30 mL of absolute alcohol per day (two standard drinks). Teratogenesis has also been noted in studies using alcohol-consuming animal models in whom the human condition is mimicked. Laboratory experiments have found that alcohol significantly impairs performance on sensory-motor and cognitive tasks at blood alcohol levels as low as 40 mg/dL. Such acute alcohol effects may contribute to other health hazards that may require medical treatment. For example, one third of all traffic fatalities are alcohol related; a significant number of industrial accidents, drownings, burns, and falls have been attributed to drinking; and a relatively high involvement of alcohol has been reported in assault, rape, child abuse and neglect, child molestation, and family violence in general. ( JAMA 1981;246:648-666)

Journal ArticleDOI
15 May 1981-JAMA
TL;DR: It is suggested that a significant proportion of patients with depression and anergia may have early hypothyroidism, the cases of about half of which are detected only by thyrotropin-releasing hormone (TRH) testing.
Abstract: To evaluate the relationship between hypothyroidism and depression, thyroid function was evaluated in 250 consecutive patients referred to a psychiatric hospital for treatment of depression or anergia. Twenty of the 250 patients had some degree of hypothyroidism. Two patients (less than 1%) were identified with grade 1 (overt); nine patients (3.6%), grade 2 (mild); and ten patients (4%), grade 3 (subclinical) hypothyroidism. These results suggest that a significant proportion of patients with depression and anergia may have early hypothyroidism, the cases of about half of which are detected only by thyrotropin-releasing hormone (TRH) testing. Because hypothyroidism can produce signs and symptoms of depression and can coexist as a second illness in depressed patients, patients with early hypothyroidism may be candidates for thyroid replacement therapy. Clinical examination and measurement of triiodothyronine resin uptake thyroxine and baseline thyroid-stimulating hormone (TSH) levels, and TSH response to TRH are necessary to identify candidates for thyroid replacement among cases diagnosed by descriptive criteria as having either major or minor depression, particularly those that are atypical or treatment resistant. ( JAMA 1981;245:1919-1922)

Journal ArticleDOI
TL;DR: The increased frequency and severity of depression in the nonfluent patients did not appear to be related to their overall physical or cognitive impairment; two possible mechanisms are discussed.

Journal ArticleDOI
TL;DR: The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatric disorders, with symptoms, personality and social state being rated independently.
Abstract: One hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. Standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year. The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness characterized by a rapid recovery after the initial assessment. Patients who reported continuous psychiatric morbidity during the year were older, physically ill and very likely to have received psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression. The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatric disorders, with symptoms, personality and social state being rated independently.

Journal ArticleDOI
TL;DR: For example, this paper found that depressed men in a college population are more likely to express social withdrawal, cognitive and motivational deficits, and somatic concerns, while depressed women are characterized on the D30 subscale of the depression scale of the MMPI.
Abstract: Considerable controversy has emerged around the issue of sex differences in depression. A recent study of a large sample of young, unmarried college student found no sex differences in degree of depression as measured by the Beck Depression Inventory, and yet significant sex differences emerged in the patterns of symptoms expressed by the most depressed subsample. It was speculated that sex differences in symptom expression may lead to sex differences in self-presentation, help-seeking, and evaluation by professionals — eventuating in predominance of women treated for depression. Two studies were conducted to clarify these issues. The first study attempted to replicate the findings on a similar large sample of college students using discriminant function analysis of male and female responses to the D30 subscale of the Depression scale of the MMPI. The results confirmed the previous finding that depressed men in a college population are more likely to express social withdrawal, cognitive and motivational deficits, and somatic concerns. Depressed women are characterized on the D30 by a lack of confidence, a lack of concern for what happens to them, and being hurt by criticism. The second study examined possible sex differences in the self-labeling of depression, attitudes toward seeking help for depression, and actual help-seeking behaviors. Men and women did not differ in willingness to report depression. However, there were clear sex differences in both help-seeking attitudes and reported behaviors, with men more reluctant to seek help.


Journal ArticleDOI
TL;DR: The incidence of diseases in the medical subspecialities of endocrinology, neurology, cardiology, gastroenterology, and rheumatology appears to be increased in patients with depression, and a causal relationship has been suggested.

Journal ArticleDOI
TL;DR: While persons with a depression use the psychiatric and general medical health care systems more frequently than those without a depression, the overall number of those who see a psychiatrist, receive a tricyclic antidepressant, or receive any treatment for their emotional problems from any source is low.
Abstract: • Data on the current prevalence of depression and its treatment derive from a longitudinal community survey conducted in 1975-1976 in New Haven, Conn. The results show the high prevalence of depression based on the Research Diagnostic Criteria. While persons with a depression use the psychiatric and general medical health care systems more frequently than those without a depression, the overall number of those who see a psychiatrist, receive a tricyclic antidepressant, or receive any treatment for their emotional problems from any source is low. Persons with a depression who do not receive treatment especially for their emotional problems make relatively frequent visits to nonpsychiatric physicians. Men and older persons who are depressed receive the least treatment.

Journal ArticleDOI
TL;DR: Of 30 patients with spinal cord lesions and depressive disorders diagnosed using the Schedule for Affective Disorders and Schizophrenia and the Research Diagnostic Criteria, 15 patients had RDC diagnoses before or after their injury, and a depressive disorder developed in nine after injury.
Abstract: Although previous studies have reported that all patients with spinal cord injuries experience depression, they have not distinguished between despondency and depressive disorder. Of 30 patients with spinal cord lesions and depressive disorders diagnosed using the Schedule for Affective Disorders and Schizophrenia and the Research Diagnostic Criteria (RDC). 15 patients had RDC diagnoses before or after their injury. A depressive disorder developed in nine after injury. Eight depressive disorders developed within a month of the injury. Postinjury depressive disorders were more common in patients with complete spinal cord lesions but were divided equally between paraplegics and quadriplegics. Only one patient received antidepressants. The remainder recovered without treatment other than the rehabilitation program. The accident causing the injury seemed related to a psychiatric disorder before injury in six patients (four alcoholics and two hypomanics) and to drinking before the accident in 15 patients.

Journal ArticleDOI
TL;DR: The authors suggest that hypothalamic-pituitary-adrenal dysfunction is associated with a type of primary depressive illness that is more likely to involve suicide than are other types.
Abstract: The authors studied 243 inpatients with unipolar depression who had received DSTs. Of 205 patients with primary depression, the 4 who later committed suicide were among 96 with abnormal DST results; 1 patients with secondary depression committed suicide despite a normal DST result. The authors suggest that hypothalamic-pituitary-adrenal dysfunction is associated with a type of primary depressive illness that is more likely to involve suicide than are other types.

Journal ArticleDOI
TL;DR: Differences between the groups suggest that depression in adult life may be related to parental rejection and control through techniques such as derision, negative evaluation, and withdrawal of affection during childhood.
Abstract: Reports of early parental behavior provided by 714 hospitalized depressed patients were compared with those provided by 387 normal adults The 2 groups were also compared on ratings of parental behavior along the acceptance-rejection and autonomy-control dimensions, based on reports of other informants Differences between the groups suggest that depression in adult life may be related to parental rejection and control through techniques such as derision, negative evaluation, and withdrawal of affection during childhood Maternal rejection was found more closely associated with depression in female than in male children, and the effect was essentially the same among black and white subjects Paternal rejection, on the other hand, appeared more closely associated with depression in males than females among blacks, while among whites paternal rejection was related to depression in females rather than males It is suggested that the thoughts of personal worthlessness and inferiority seen in depression and theorized by Beck to be of principal etiologic significance in the disorder may have their origin in the early parent-child relationships

Journal ArticleDOI
TL;DR: It is concluded that such ST-segment depression is not associated with a poor prognosis and there is rarely a need to resort to cardiac surgery; medical management is highly successful andassociated with a low mortality.
Abstract: Reproducible and profound (greater than 2 mm) ST-segment depression during exercise testing in patients with coronary heart disease is associated with multivessel involvement. In these patients, coronary-artery bypass surgery has been recommended even when symptoms are absent. However, there are few long-term follow-up data regarding the prognosis when such patients are treated medically. Among 212 men with coronary-artery disease in whom profound ST-segment depression could be reproduced with exercise, 142 who had no other type of heart disease and were not receiving digitalis drugs had a mean ST-segment depression of 2.9 mm. Follow-up has lasted an average of 59 months: 11 patients have died (annual mortality, 1.4 per cent), and nine have had bypass operations (1.3 per cent per year). Survival correlated with exercise tolerance but not with degree of ST depression, peak heart rate, or peak blood pressure during exercise. We conclude that such ST-segment depression is not associated with a poor prognosis. There is rarely a need to resort to cardiac surgery; medical management is highly successful and associated with a low mortality.


Book
01 Jan 1981
TL;DR: Reading behavior therapy for depression present status and future directions is also a way as one of the collective books that gives many advantages.
Abstract: No wonder you activities are, reading will be always needed. It is not only to fulfil the duties that you need to finish in deadline time. Reading will encourage your mind and thoughts. Of course, reading will greatly develop your experiences about everything. Reading behavior therapy for depression present status and future directions is also a way as one of the collective books that gives many advantages. The advantages are not only for you, but for the other peoples with those meaningful benefits.

Journal ArticleDOI
TL;DR: The study indicates that mental illness, especially depressive disorder, implies a considerably increased risk of suicide in men without a psychiatric diagnosis and among men with depression.
Abstract: In the present investigation we have used a longitudinal psychiatric-epidemiological study of 3,563 persons who, at a certain date 1947 or 1957, were registered in a geographically well-defined area in Sweden, "Lundby". This population has been observed and psychiatrically evaluated for 25 and 15 years, respectively. During the observation period 23 men and 5 women committed suicide. In the total Lundby cohort the age-standardized male suicide rate was 51 per 100,000 person years. The corresponding rate in men without a psychiatric diagnosis was 8.3, among men who had suffered some kind of psychiatric disorder other than depression 83, and among men with depression 650. The study thus indicates that mental illness, especially depressive disorder, implies a considerably increased risk.

Journal ArticleDOI
TL;DR: Post-Vietnam syndrome is characterized by intrusive, combat-related thoughts and nightmares, numbed responsiveness, and several specific symptoms such as drug dependence, depression, anxiety, and rage.

Journal ArticleDOI
TL;DR: Three diagnostic errors appeared particularly important: failure to recognize depression, especially in the presence of mild organic brain disease; equating brain atrophy on the computerized tomogram with clinical dementia; and failure to distinguish focal from global intellectual impairment.
Abstract: Accurate diagnosis of the dementias is difficult. Of 100 patients referred to a specialized outpatient dementia clinic, at least 26 were not demented. Fifteen had depression, 7 had miscellaneous other neuropsychiatric disorders, and 4 were normal. Specialized dementia clinics help to improve diagnostic accuracy. Three diagnostic errors appeared particularly important: failure to recognize depression, especially in the presence of mild organic brain disease; equating brain atrophy on the computerized tomogram with clinical dementia; and failure to distinguish focal from global intellectual impairment. For confirmation, the diagnosis of dementia requires follow-up evaluation, brain biopsy, or autopsy.