Which clinical profile most strongly suggests depressive pseudodementia rather than true dementia in an elderly patient with apparent cognitive impairment?
- A Insidious onset with the patient minimising deficits and confabulating to cover them
- B Abrupt onset, prominent complaints of poor memory, little effort on testing, and 'I don't know' answers ✓
- C Stepwise decline with focal neurological signs and gait disturbance
- D Fluctuating cognition with well-formed visual hallucinations and parkinsonism
Correct answer: B. Abrupt onset, prominent complaints of poor memory, little effort on testing, and 'I don't know' answers
Explanation
Depressive pseudodementia typically has an abrupt onset, prominent subjective memory complaints disproportionate to objective findings, poor effort with 'I don't know' responses, and visible distress about performance. Patients with true dementia often minimise deficits, confabulate, and make errors confidently. Option A describes the typical attitude in Alzheimer's disease, which kills that distractor. Treatment of depression improves the cognitive picture.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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