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Saturday, May 1, 1999 Published at 02:48 GMT 03:48 UK


CJD mimics psychiatric disorders

CJD may have similar symptoms to depression

Psychiatrists have warned that it is almost impossible to distinguish the early symptoms of new-variant Creutzfeldt-Jakob disease (nvCJD) from psychiatric disorders.

NvCJD is a fatal neurological disorder thought to be caused by the same agent responsible for Bovine Spongiform Encephalopathy, or mad cow disease, in cattle.

Psychiatrists have studied 33 patients who have contracted the disease out of the 35 cases confirmed in the UK.

Writing in Psychiatric Bulletin, the journal of the Royal College of Psychiatrists, a team from the National CJD Surveillance Unit at Western General Hospital, Edinburgh, warn that many of the patients were initially thought to be suffering from a psychiatric illness rather than a neurological disorder.

Of the 33 cases, 16 demonstrated symptoms of depression, 17 of anxiety and 19 of being withdrawn.

However, the researchers say there are some early symptoms of the disease that do point to a neurological disorder. These include:

  • Impairment of thought (cognitive) processes
  • Persistent limb pain
  • Problems with balance when walking
  • Speech problems
  • Visual impairment

The researchers say although CJD is a rare disease there is a possibility that large numbers of cases could occur in the future, and that psychiatrists should be aware of the psychiatric symptoms.

They write: "The diagnosis of new-variant CJD, and its distinction from common psychiatric disorders, may not be possible in the early stages of the illness.

"Even after neurological symptoms develop there may be great difficulty distinguishing between psychiatrically determined neurological features and symptoms due to an underlying organic neurological disease."

The difficulty in diagnosing new-variant CJD is also compounded by the fact that some of the psychiatric symptoms will respond to treatment with anti-depressants.

"There is, however, an imperative to try and improve the early diagnosis of new-variant CJD," they write.

"The failure to make this diagnosis may later be interpreted by family members as a failure on the part of the psychiatrist.

"Delay in diagnosis is distressing to the relatives of patients, particularly in conditions such as new-variant CJD in which there is a progressive decline in function requiring increasing levels of care."

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