Pseudodementie, een achterhaald begrip
The term 'dementia' may be used to denote a nosological entity or a syndrome. The concept of 'pseudodementia' is rooted in the traditional nosological view on dementia; moreover, it is based on the opinion that there exists a sharp distinction between 'organic' and 'functional' disorders in psychogeriatrics. In this article an analysis of the current use of the concept 'pseudodementia' is given. It is shown, that, in many cases, its application is superfluous (Ganser syndrome, mania, schizophrenia, delirium, confusional states and reversible somatic diseases with cognitive disturbances); in other cases its use can impede the clinician in recognizing the interplay between 'organic' and 'functional' etiological factors that commonly exists in psychogeriatrics. This is illustrated by four case histories, two examples of so-called depressive pseudodementia and two of hysterical pseudodementia.
It is concluded that the concept of 'pseudodementia' is outdated, and that, in psychogeriatrics too, time has come to change the nosological for the syndromal approach of 'dementia'.