Table 8

Differential diagnosis between dementia and depressive pseudodementia

FeaturesDementiaDepressive pseudodementia
OnsetInsidiousSudden (may recall the exact time of symptoms onset)
EvolutionSlowFast
Psychiatric historyNegativeMay be positive
AwarenessReduced or absentPreserved
Functional deficitsPatient may deny or minimisePatient may emphasise
MoodIncongruous or fluctuatingDepressed
Neuropsychological testsWorsens on repeated testingImproves or stable on repeated testing
Instrumental testsMR scan, positron emission tomography scan or biomarkers positiveNegative
Effect of treatmentNo change with antidepressantsMay improve on antidepressants