Differential diagnosis between dementia and depression: a study of efficiency increment

Abstract

A battery of neuropsychological tests was examined to establish its value in differentiating mild dementia from depression. The battery was applied to 84 subjects: 31 dementia patients of several etiologies, 31 patients with major depression and 22 volunteers whose age and educational level was similar to that of the patients. The battery consisted of tests for immediate, recent and remote memory, the Mini Mental State examination, a screening test for language disorders, and tests measuring abstraction, calculation, judgement, praxic and gnosic functions. The results showed significant differences among the three groups in all memory tests. Deficits of abstraction, calculation, praxis and language functions were strongly associated with dementia. The epidemiological analysis of efficiency increment, with determination of sensitivity and specifity, showed a highly significant enhancement of efficiency for diagnostic purposes when the results of the tests were combined. These findings suggest that the entire battery of neuropsychological tests should be applied, and their results compared using the efficiency increment procedure, in order to establish a firm differential diagnosis between dementia and depression, and/or to detect the former when it is at a mild early stage.

Neuropsychological Clustering in Bipolar and Major Depressive Disorder

“…In addition to these instruments, participants were administered the Mini-Mental State Examination (MMSE; Folstein, Folstein, & McHugh, 1975; adapted by Chaves & Izquierdo, 1992) with cutoffs adjusted for education by Kochhann, Varela, Lisboa, and Chaves, (2010), to screen for symptoms of dementia. Additionally, the Block Design and Vocabulary Subtests from the Wechsler Adult Intelligence Scales (WAIS-III) (Nascimento, 2004) were used to estimate participant intelligence quotient (IQ) based on the values provided by (Jeyakumar, Warriner, Raval, & Ahmad, 2004).…”

A cultural study on decision making: performance differences on the Iowa gambling task between selected groups of brazilians and americans

“…The following instruments were administered to each Brazilian participant individually in a single session at the Neuropsycholinguistics Laboratory of the Universidade Federal do Rio Grande do Sul or at the participant's home. Before administering the IGT, the examiner administered the following screening instruments: MMSE (Folstein, Folstein, & McHugh, 1975; adapted for Brazilian Portuguese by Chaves & Izquierdo, 1992), the Modified Mini International Neuropsychiatry Interview (MINI) (Sheehan et al, 1998; validated for the Brazilian population by Amorim, 2000), and a Demographic Data Questionnaire. The MMSE was only used with elderly individuals because most of the young adults were college students who were regularly engaged in intellectual activity.…”

Estudo de fidedignidade do instrumento neuropsicológico Iowa Gambling Task

“…Foram selecionados em ambientes universitários, de trabalho e em centros de convivência, sendo a amostragem por conveniência. Ingressaram na amostra somente os participantes que, além dos critérios de idade e escolaridade, não apresentassem: (a) quaisquer distúrbios sensoriais (auditivos e/ou visuais) não corrigidos; (b) sinais sugestivos de quadros neurológicos e/ou psiquiátricos, examinados pelo questionário sociocultural e de aspectos de saúde 23 ; (c) sinais de depressão mensurados pelo Inventário Beck de Depressão (BDI-II) (Beck; Steer; Brown, 1996, adaptado ao português brasileiro por Finger e Argimon 24 , com escore > 19); (d) demência, em triagem feita pelo Miniexame do Estado Mental (MEEMadaptado para a população local por Chaves e Izquierdo 25 , com escore ≥ 24); (e) histórico de alcoolismo, triados com a escala CAGE (versão utilizada no estudo de Amaral e Malbergier 26 , com escore ≥ 2); (f) relato de uso abusivo atual ou prévio de drogas ilícitas ou de benzodiazepínicos (avaliado por autorrelato em um questionário sociocultural); e (g) escores ponderados inferiores a sete nos subtestes Vocabulário e Cubos do WAIS-III 27 . A amostra foi composta apenas por participantes brasileiros natos e falantes do português brasileiro.…”