Dazed and confusing -- two cases of early onset dementia presenting with neuropsychiatric symptoms.

Introduction: Early Onset Dementia (EOD) refers to cases occurring in adults before age 65. Risk factors vary according to etiology, the most common being Neurodegenerative. The onset is usually insidious. Early personality and behavioral changes may lead to Psychiatric referral, delaying definitive diagnosis. Objectives: We aim to discuss diagnostic challenges of EOD in a Psychiatric inpatient service. Methods: Description of two clinical cases of EOD, from the inpatient psychiatric service of CHVNG. Non systematic review of literature. Results: Case 1: R., age 54, male, long distance driver. History of cerebrovascular disease. No previous psychiatric history. May 2018: presents to the Psychiatric Emergency Service (PES), with low mood, self-harming behaviour, suicidal ideation, and recent cognitive difficulties. Committed for a short period and medicated with antidepressants, maintaining symptoms in follow up. December: presented to PES with agressive behaviour and persecutory delusions. A diagnosis of probable Alzheimer's Dementia, mixed presentation, was established. Case 2: M., age 61, female. History of a depressive episode in 2012, treated with antidepressants, total remission; other history unremarkable. Presented to PES in July 2019, with psychomotor agitation, aggression, disinhibition, and coprolalia. Mnestic deficits of insidious onset. More recently, executive dysfunction. A diagnosis of Mixed Dementia was established. Conclusions: These cases represent different profiles of neuropsychiatric presentation of dementia. Patients with EOD may first present to psychiatric services with early unspecific symptoms, mimicking primary psychiatric disorders, or with exuberant, disruptive behavioural symptoms. A thorough organic evaluation is essential, to rule out delirium and reversible causes of dementia, and establish the correct diagnosis and treatment. [ABSTRACT FROM AUTHOR]