[On the problem of depressive pseudodementia]

Abstract

The term "depressive pseudodementia" introduced 20 to 30 years ago by Madden and coworkers and by Kiloh is critically evaluated. This originally descriptive term is not unequivocal due to its diagnostic and therapeutic connotations. Even by omitting the negative prefix "pseudo" it cannot be distinguished whether a psychopathological description of symptoms or a clinical diagnosis is meant. Therefore, on the present state of knowledge of dementia research and in view of the necessary distinction between syndromal and nosological classification level, the authors favour the abandoning of the term "depressive dementia". At the syndromal level it is suggested to use the term "dementia syndrome" according to Folstein and McHugh or to use the term "cognitive impairment" according to Caine. At the diagnostic-nosological level this procedure should include the information as to whether the "cognitive impairment" of an elderly patient coincides with a depression, a certain type of dementia or a combination of both. Such a positive terminology may promote the qualitative differentiation and quantification of the "cognitive impairment" which are scientifically necessary.