confused about pseudodementia diagnosis!

[orange_peel_]

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Does pseudo dementia need to meet the same diagnostic criteria as MDD? (Depression or anhedonia + 5 of SIGECAPS)

I came across an NBME question where an elderly woman presented with memory loss, and trouble sleeping etc... but there was NO mention of "feeling depressed" or irritability etc. Also no mention of whether her interest in hobbies/activites etc had changed. The correct answer was MDD.

I counted her sx and it seemed like she did NOT meet the strict definition of MDD that we use for adults. Are we supposed to assume the pt's memory loss is a manifestation of her depression (so memory loss counts as "depression")???

TYIA, I'm taking Step 2 very soon!

 

[premed8888]

Pseudodementia will look like dementia at first glance in an older patient. They will be forgetful and the stem may try to fool you by using certain buzz situations such as the patient is forgetting to pay bills or leaves his or her keys places. However, the great divide between dementia and psuedodementia is that the patient will REALIZE he or she is forgetting things and this may bother him or her. In true dementia, such as Alzheimer's dementia, the patient will NOT realize this decline. They may not meet the strict definition of MDD in the stem because that is too easy - look at the surrounding information holistically. It may not say "the patient reports less energy than normal" but may say the patient jogs only once per week whereas he or she used to go out 3-4x per week (could also represent decreased interest) etc.