Pseudodementia masking substance abuse and depression.

Even though it is well known that substance abuse may be the presenting disorder of patients who attempt to treat themselves for an underlying depression, this problem remains difficult to identify in apparently reliable persons who deny medication abuse and who seem to be suffering from another disorder. We recently encountered a woman who developed an acute organic mental state which, when properly diagnosed and treated, was replaced by what seemed to be a chronic brain syndrome. This apparently organic disorder responded to treatment for a severe masked depression.