Depression and Pseudodementia

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The essential feature of major or clinical depression is either depressed mood or the loss of interest or pleasure in nearly all activities during a period of at least 2 weeks (APA, 1994). Additional symptoms that may be present include sleep and/ or eating disturbances, psychomotor retardation or agitation, loss of energy, difficulties in thinking or concentration, and suicidal ideation. Typically, intelligence tests are not used as the primary assessment tool in diagnosing depression; however, they can be useful to this end. For instance, many individuals with learning disabilities also have major depression (APA, 1994; Culbertson & Edmonds, 1996). Additionally, it can be difficult, particularly in elderly persons, to determine whether cognitive symptoms are due to dementia or to a major depressive episode (APA, 1994). In fact, the literature suggests that the cognitive symptoms associated with depression are the most common type of "pseudodementia" and the most easily misdiagnosed (Lishman, 1987). Thus, neu-ropsychological testing and other tests assessing cognitive abilities can be helpful in the differential diagnosis of depression versus other disorders.

Although research with the KAIT and depressed patients is limited, an initial study found that a sample of patients with clinical depression (N = 44) did not differ from their matched controls on any subtest of the KAIT (Kaufman & Kaufman, 1993; Grossman, Kaufman, Med-nitsky, Scharff, & Dennis, 1994). One significant difference between depressed and nondepressed subjects was found regarding the size of the discrepancy between scores on Auditory Comprehension and Auditory Delayed Recall (tasks of

TABLE 13.15 Hypothesized KAIT results for clients with Alzheimer's-type dementia

Symptom

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