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A case of dementia or simple schizoprenia?

Published online by Cambridge University Press:  16 April 2020

C. Lee*
Affiliation:
Community Psychiatry, Institute of Mental Health, Singapore, Singapore

Abstract

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Introduction

This is a case report of a Chinese middle-aged female who was first seen in 2006 for suspected depression. Over the course of the illness, her diagnosis was revised to that of Simple Schizophrenia and then Frontoparietal Dementia.

Case

A 53 years old Chinese lady was first brought by a male friend (who has known her for past 21 years) in 2006 to continue management for her depression. For the preceding 3–4 years, her behaviour has been very child-like. She was described premorbidly to be stubborn and independent. Mental state examination then revealed that she was oriented to time, place and person. Her mood appeared depressed and reactive (secondary to some social stressors). Patient refused any basic blood investigations and her antidepressant was continued. Over the course of few months, she started to complain of forgetfulness and she was reported to go ‘missing’ for 1 to 2 hours. A differential diagnosis of chronic negative symptoms schizophrenia was entertained. In August 2007, she was arrested for shoplifting and was treated as an inpatient. Upon discharge, she was referred to a nursing home. By October 07, she was totally disoriented to time and place. Computed Axial Tomography (CAT) scan of brain was eventually performed which reported as ‘knife-shaped appearance’ of cortical gyri suggestive of frontoparietal dementia, possible Pick’s Disease. Patient is currently on antidementia therapy.

Conclusion

The case report illustrates the importance of entertaining diagnosis of dementia in a middle-aged person especially with symptoms of regression and wandering behaviour.

Type
P01-485
Copyright
Copyright © European Psychiatric Association2011
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