D
Daytime Sleepiness
• Medication induced (e.g., benzodiazepines, β-blockers, narcotics, sedative antidepressants, gabapentin)
Delirium27
PHARMACOLOGIC AGENTS
Dementia with Lewy Bodies
• Parkinson’s disease dementia (PDD): differentiated from DLB, in which dementia usually precedes parkinsonism. A somewhat arbitrary “1-year” rule is sometimes used to differentiate DLB from PDD in that if dementia presents within the first year after the parkinsonism, DLB can still be diagnosed.
• Alzheimer’s disease (AD): differs from DLB, in which visual hallucinations and parkinsonism are prominent.
• Atypical parkinsonian syndromes (multiple systems atrophy, progressive supranuclear palsy, corticobasal degeneration): these syndromes have other features, such as cerebellar degeneration, supranuclear gaze palsy, and asymmetric limb apraxia, that are not seen in DLB.
• Vascular dementia: differs from DLB in that despite the fluctuations in performance seen in DLB, there is no clear history of multiple strokes.
Demyelinating Diseases40
Dependent Personality
• Dependency and personality changes arising as a consequence of an Axis I disorder, such as mood disorders, social anxiety, panic disorder, and agoraphobia
• Most common comorbid Axis I conditions are major depressive and other mood disorders, anxiety disorders, including social phobia, and adjustment disorder.
• Most common comorbid personality disorders are histrionic, avoidant, and borderline. Each of these disorders is characterized by dependent features. Dependent personality disorder (DPD) is distinguished by its predominantly submissive, reactive, and clinging behavior.
• Borderline: also fears abandonment but reacts to abandonment with rage rather than urgent efforts to replace the relationship. Also unstable relationships in borderline.
Depression
• Major organ system disease (e.g., cardiovascular, liver, renal, neuronal diseases) with depressive symptoms
