Descriptive Psychopathology: The Signs and Symptoms of ...

330 Section 3: Examination domainsfrontal dementia versus Alzheimer’s disease, amnestic syndromes, subcorticalversus cortical disease, and left versus right cerebral hemisphere disease.Many classic psychiatric syndromes are associated with cognitive difficultiesand some syndromes are delineated by the presence of cognitive impairment(e.g. melancholia versus non-melancholic depression). Cognitive assessment is thereforepart of a thorough behavioral evaluation and is not limited to those patientssuspected of having a brain lesion. Cognitive assessment is important for diagnosis,estimating prognosis, treatment planning, and the monitoring of treatments.NOTES1 Kahlbaum (1874/1973), page 4.2 Taylor and Fink (2006).3 Bowie et al. (2004); Sapara et al. (2007).4 Purcell et al. (1998); Chamberlain et al. (2007).5 Duara et al. (1999).6 Fielding et al. (2006); Chang et al. (2007).7 Feinberg and Roane (2005).8 Critchley (1953); Maruff et al. (2005); Ishii et al. (2006).9 Gouzoulis-Mayfrank et al. (2000); Cunha et al. (2004); Reay et al. (2006).10 APA (2001).11 Taylor and Fink (2006), chapters 6 and 12.12 Tippett and Sergio (2006).13 See previous chapters for discussions of the specific associations of psychopathology andcognitive dysfunction.14 The WAIS (The Wechsler Adult Intelligence Scale) was one of the earliest psychological testbatteries used as a cognitive assessment instrument rather than as a measure of IQ only. Theage-corrected norm is about 100. Patient 13.3 was seen by one of us many years ago. Today,several bedside tests would have revealed his deficits as clearly as did the WAIS.15 For further reading about cognitive testing and neuropsychological concepts that underlietesting , see Taylor ( 1999, chapters 1 and 4), Kolb and Whishaw (1996 ), and Lezak et al.(2004).16 Gillis and MacDonald (2006).17 There are exceptions. Anticholinergic intoxication is characterized by dry skin and mucosa,a facial flush, dilated pupils, tachycardia, and low-grade fever. Wernicke’s encephalopathy ischaracterized by nystagmus, ophthalmoplegia, and peripheral neuropathy. Delirium tremensis characterized by a coarse bilateral tremor and often the patient has other signs of chronicalcoholism.18 Amieva et al. (2004); Helmer et al. (2006).19 Draper (1991).20 Lopez et al. (2005).