Episode of mixed mood with psychotic features secondary to Binswanger disease: A case report with a literature review

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Abstract

Neurodegenerative and mood disorders in the geriatric population might exhibit interchangeable cognitive and behavioural symptoms. This overlap in presentation might raise a diagnostic challenge for psychiatrists evaluating elderly patients who are presenting with such symptoms. Additionally, there is limited data published about early psychiatric manifestations of neurodegenerative disorders in the elderly. We report a case of a 71-year-old with a history of refractory depressive disorder and multiple cardiovascular risk factors presenting with verbalisation of suicidal and homicidal intent as well as mixed mood and psychotic symptoms. The patient was diagnosed with Binswanger's disease (BD). We also provide a literature review of challenging early psychiatric presentations of neurocognitive disorders and a summary of similar cases to help facilitate diagnosis of BD cases in future. © 2021 American Society of Civil Engineers (ASCE). All rights reserved.

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Dementia, Mood disorders (including depression), Psychiatry of old age, Vascular, Aged, Dementia, vascular, Humans, Mood disorders, Psychotic disorders, Amlodipine plus telmisartan, Atorvastatin, Bisoprolol fumarate, Bromazepam, Carbamazepine, Clomipramine, Clopidogrel, Hydrochlorothiazide, Quetiapine, Risperidone, Anxiety, Anxiety disorder, Article, Aspiration pneumonia, Binswanger encephalopathy, Cardiovascular disease, Cardiovascular risk factor, Case report, Clinical article, Clinical feature, Cognitive function test, Drug dose reduction, Dyslipidemia, Electroconvulsive therapy, Emergency ward, Evening dosage, Grandiose delusion, Homicide, Human, Hyperphagia, Hypertension, Impulsiveness, Irritability, Laboratory test, Length of stay, Major depression, Male, Metabolic syndrome x, Mini mental state examination, Mood disorder, Nuclear magnetic resonance imaging, Obesity, Paranoia, Psychiatrist, Psychosis, Single drug dose, Sinus tachycardia, Speech disorder, Suicidal ideation, Thought disorder, Veteran, Multiinfarct dementia

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