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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Depression. MRI Shows NAD. Done Blood Test. Cause Of Aggression?

My dad is 78 and has suffered deression since nov, in the last week has become confused at times and has a couple of nights where he is aggressive which is uncharactoristic, normally active and well, today he had an mri which was nad, bloods showed sodium of 126, ddimers 4 times the norm and crp of 60. He has been admitted to hospital but has become very aggressive, could the above cause this ?
Sat, 30 Mar 2013
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Psychiatrist,  's  Response
Hello helencagney
Welcome to HCM

At the age of 78 severe depression may be due to a number of reasons-
- Dementia is one of major cause at this age, which may show clinical picture of depression and forgetfulness.
- Second cause that is most likely at this age and with this symptomatology is Delirium secondary to dementia, as he is 78 and his Sodium levels are 126 which is in normal range, also CRP is high this means that he is having some sort of infection. So probably he is in delirium, which is causing aggression in him. Loss of orientation is also a feature of delirium.
He should be kept in intensive care unit with well lighted room, with window, a paper and pan should be kept with him, try to talk to him. Rest is on team of his attending doctors. Psychiatry opinion is necessary in him.
Thanks
Take Care
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2 Doctors agree with this answer

Psychiatrist,  Dr. Sundar Gnanavel's  Response
Hello.............
Thanks for your query. The symptoms you report point towards the following differential diagnosis considering the age of your father:
1. Dementia (early stage considering normal MRI)
2. Delirium (drug induced/deranged serum electrolytes)
3. Late onset psychosis/paraphrenia
4. Late onset mood disorder
Hence, i would recommend a psychiatric evaluation to clinch the right diagnosis. Usually low dosage antipsychotics are preferred considering his age and propensity to develop side effects with medication. Wish him early recovery.
Regards
Dr Sundar
Psychiatrist
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Have Depression. MRI Shows NAD. Done Blood Test. Cause Of Aggression?

Hello helencagney Welcome to HCM At the age of 78 severe depression may be due to a number of reasons- - Dementia is one of major cause at this age, which may show clinical picture of depression and forgetfulness. - Second cause that is most likely at this age and with this symptomatology is Delirium secondary to dementia, as he is 78 and his Sodium levels are 126 which is in normal range, also CRP is high this means that he is having some sort of infection. So probably he is in delirium, which is causing aggression in him. Loss of orientation is also a feature of delirium. He should be kept in intensive care unit with well lighted room, with window, a paper and pan should be kept with him, try to talk to him. Rest is on team of his attending doctors. Psychiatry opinion is necessary in him. Thanks Take Care