Case report
https://doi.org/10.20471/dec.2021.57.02.09
Case Report on a Misdiagnosed Case of Subcortical Vascular Dementia – the Importance of Sound Knowledge of Psychiatry With Proper History Taking
Natasha Subhas
; Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Klang, Malaysia
Nicholas Tze Ping Pang
; Department of Psychiatry, Faculty of Medicines and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
Kok Yoon Chee
; Department of Psychiatry and Mental Health (Neuropsychiatric and Neuromodulatory unit - NEURON), Kuala Lumpur, Malaysia
Norzaini Rose Mohd Zain
; Department of Radiology and Diagnostic Imaging (Neuroradiology), Kuala Lumpur, Malaysia
Kok Liang Teng
; Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Klang, Malaysia
Sandi James
; Department of Psychiatry, Faculty of Medicines and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
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 etiologies are ruled out in clients with relevant sociodemographic and clinical risk factors.
Keywords
dementia; depression; post stroke; neuropsychiatry; organicity
Hrčak ID:
257568
URI
Publication date:
1.6.2021.
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