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From: TSS ()
Subject: Psychiatric Manifestations of CJD: A 25-Year Analysis
Date: January 9, 2006 at 2:22 pm PST

Psychiatric Manifestations of CJD: A 25-Year Analysis
Mon Jan 9, 2006 11:54

J Neuropsychiatry Clin Neurosci 17:489-495, November 2005
doi: 10.1176/appi.neuropsych.17.4.489
© 2005 American Psychiatric Publishing, Inc.

Psychiatric Manifestations of Creutzfeldt-Jakob Disease: A 25-Year Analysis
Christopher A. Wall, M.D., Teresa A. Rummans, M.D., Allen J. Aksamit, M.D., Lois E. Krahn, M.D. and V. Shane Pankratz, Ph.D.
Received April 20, 2004; revised September 9, 2004; accepted September 13, 2004. From the Mayo Clinic, Department of Psychiatry and Psychology, Rochester, Minnesota; Mayo Clinic, Department of Neurology, Rochester, Minnesota. Address correspondence to Dr. Wall, Mayo Clinic, Department of Psychiatry and Psychology, Mayo Building-W11A, 200 First St., SW, Rochester, MN 55905; (E-mail).

This study characterizes the type and timing of psychiatric manifestations in sporadic Creutzfeldt-Jakob disease (sCJD). Historically, sCJD has been characterized by prominent neurological symptoms, while the variant form (vCJD) is described as primarily psychiatric in presentation and course: A retrospective review of 126 sCJD patients evaluated at the Mayo Clinic from 1976–2001 was conducted. Cases were reviewed for symptoms of depression, anxiety, psychosis, behavior dyscontrol, sleep disturbances, and neurological signs during the disease course. Eighty percent of the cases demonstrated psychiatric symptoms within the first 100 days of illness, with 26% occurring at presentation. The most commonly reported symptoms in this population included sleep disturbances, psychotic symptoms, and depression. Psychiatric manifestations are an early and prominent feature of sporadic CJD, often occurring prior to formal diagnosis.



Historically, psychiatric manifestations have been described as a relatively
infrequent occurrence in the sporadic form of creutzfeldt-Jakob disease.
However, our findings suggest otherwise. In this study, a vast majority of
the cases were noted to have at least one psychiatric symptom during the
course of illness, with nearly one-quarter occurring in the prodromal or
presenting phase of the illness. After comparing the frequency of
neuropsychiatric symptoms in sporadic CJD to studies describing the variant
form of CJD, we found that there are fewer clinical differences than
previously reported.5-7 While the age of patients with vCJD presentation
is significantly younger and the course of illness is longer, the type and
timing of psychiatric manifestations appear similar between these two
diseases. ...snip...end.


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