Case report on a misdiagnosed case of subcortical vascular dementia – the importance of sound knowledge of psychiatry with proper history taking

Natasha Subhas and Pang, Nicholas Tze Ping and Kok, Yoon Chee and Norzaini Rose Mohd Zain and Kok, Liang Teng and Sandi James (2021) Case report on a misdiagnosed case of subcortical vascular dementia – the importance of sound knowledge of psychiatry with proper history taking. Archives of Psychiatry Research, 57. pp. 209-218. ISSN 2671-1079 (P-ISSN) , 2671-2008 (E-ISSN)

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URL: https://hrcak.srce.hr/file/374357

Abstract

Psychiatric symptoms at presentation may often be missed, if not suspected or specifically explored. A missed psychiatric diagnosis may lead to dire consequences in terms of poor quality of life and function for the patient, affecting overall quality of healthcare provided. This lady presented with depressive symptoms after multiple strokes and was initially diagnosed as post stroke depression. However, after it was observed that she did not show any improvement in symptoms despite being on antidepressants, subsequent further investigations revealed a history more suggestive of subcortical vascular dementia. Consequently, detailed neuropsychological and neuropsychiatric assessments, including NUCOG, and relevant investigations including MRI brain scans were performed suggesting a diagnosis of vascular dementia. This case illustrates that an insufficiently thorough assessment and treatment process results in unnecessary morbidity, prolongs duration of illness, and increases social and occupational dysfunction to the patient. Hence, it further underscores the need to perform a thorough history, physical examination and relevant investigations to ensure organic aetiologies are ruled out in clients with relevant sociodemographic and clinical risk factors.

Item Type:	Article
Keyword:	Dementia , Depression , Post stroke , Neuropsychiatry , Organicity
Subjects:	R Medicine > RC Internal medicine > RC31-1245 Internal medicine > RC321-571 Neurosciences. Biological psychiatry. Neuropsychiatry > RC346-429 Neurology. Diseases of the nervous system Including speech disorders > RC435-571 Psychiatry
Department:	FACULTY > Faculty of Medicine and Health Sciences
Depositing User:	SAFRUDIN BIN DARUN -
Date Deposited:	08 Jun 2022 09:43
Last Modified:	08 Jun 2022 09:43
URI:	https://eprints.ums.edu.my/id/eprint/32647

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