Godot Syndrome in an Elderly Patient with Pseudodementia

老年假性失智症患者的Godot症候群

10.29478/TJP.201003.0010

蔡咏良(Yung-Lang Tsai)；蔡世仁(Shih-Jen Tsai)；黃正平(Jeng-Ping Hwang)；劉慕恩(Mu-En Liu)

Godot症候群 ； 假性失智症 ； 老年人 ； Godot syndrome ； pseudo-dementia ； elderly

台灣精神醫學

24卷1期（2010 / 03 / 01）

78 - 80

英文

目的：Godot症候群是一種非常罕見的特殊焦慮症狀，特屬於失智症患者所表現出來的精神行為症狀之一，被認為是個案患有失智症之後，因明顯認知功能受損，所反應出來之特殊心理狀態及特殊焦慮症狀，以往，只有少數個案出現於阿茲海默症(Alzheimer's disease)病程中，於假性失智症(pseudo-dementia)的老年憂鬱症患者中，並無文獻提及此症狀的出現。病例報告：70歲的女性假性失智症病患，呈現出明顯的Godot症候群，在治療三個月之後，其Godot症狀逐漸改善。結論：老年患者的Godot症候群，除需考慮失智症之外，也必須考慮到假性失智症的可能性。

Objective: Godot syndrome is categorized as a variant of anxiety and a psychological symptom of dementia. We present a case of Godot syndrome in an elderly patient with pseudo-dementia. The patient's Godot syndrome and dementia-like symptoms were improved progressively after receiving treatment with an antidepressant. Case report: A 70-year-old widow presented with Godot syndrome and dementia-like symptoms after her husband's death. She became extremely dependent on others and caused a severe burden for her caregiver. Her symptoms started to subside after three months of medication treatment and she recovered her normal functioning to the premorbid level. Conclusion: If the first appearance of Godot syndrome and memory complaints occur in a patient's late life, pseudodementia should be included in the differential diagnosis. The use of an adequate course of an antidepressant treatment is included in the initial work up for any patient who is suspected to have dementia. The timely diagnosis and the right treatment fully improved the patient's symptoms.

1. Burgmans, S.,van Boxtel, M.P.,Smeets, F.(2008).Prefrontal cortex atrophy predicts dementia over a six-year period.Neurobiol Aging
2. Caine, E.D.(1981).Pseudodementia: current concepts and future directions.Arch Gen Psychiatry,38,1359-64.
3. Finkel, S.(2003).Behavioral and psychologic symptoms of dementia.Clin Geriatr Med,19,799-824.
4. Ishizaki, J.,Yamamoto, H.,Takahashi, T.(2008).Changes in regional cerebral blood flow following antidepressant treatment in late-life depression.Int J Geriatr Psychiatr,23,805-11.
5. Kloszewska, I.(1998).Incidence and relationship between behavioral and psychological symptoms in Alzheimer's disease.Int J Geriat Psychiatry,13,785-92.
6. LeDoux, J.(2003).The emotional brain, fear, and the amygdala.Cellul Mol Neurobiol,23,727-38.
7. Mintzer, J.E.,Brawman-Mintzer, O.,Mirski, D.F.(2000).Anxiety in the behavioral and psychological symptoms of dementia.Int Psychogeriatr,12(supl 1),139-42.
8. Peciña, S.,Smith, K.S.,Berridge, K.C.(2006).Hedonic hot spots in the brain.Neuroscientist,12,500-11.
9. Reisberg, B.,Auer, Stefanie R.,Monteiro, Isabel(1996).Behavioral disturbances of dementia: an overview of phenomenology and methodologic concerns.Int Psychogeriatr,8(supl 2),169-80.
10. Rogers, M.A.,Kasai, K.,Koji, M.(2004).Executive and prefrontal dysfunction in unipolar depression: a review of neuropsychological and imaging evidence.Neurosci Res,50,1-11.