Pseudobulbar Affect Mimicking Depression: A Case Report

Pseudobulbar affect (PBA) is a neurological condition that is associated with short periods of involuntary, sudden, and inappropriate emotions such as crying or laughing, which are mood incongruent. An accurate estimate of the prevalence of PBA is hard to obtain due to varying diagnostic criteria and variable patient populations. The cause of PBA is not known, but current evidence suggests dual etiology. A neural circuit dysfunction and an abnormality of neurotransmitters that regulate motor expression of emotions. PBA can easily be mistaken for a depressive disorder due to the overlap of symptoms. Moreover, patients with PBA may have a major depressive disorder (MDD) or other depressive disorders. Therefore, it is essential to recognize and treat PBA as well as possible psychiatric comorbidities. We present a case report of a 59-year-old man with no past psychiatric history who presents with paroxysms of episodes of crying for the past one year. He endorsed feelings of hopelessness and poor concentration. MRI of the brain revealed bilateral basal ganglia and a thalamic infarct. The patient was treated with citalopram. This case describes a unique presentation of pseudobulbar affect mimicking depression.

Automated summary

Pseudobulbar affect (PBA) is a neurological condition characterized by spontaneous and uncontrollable episodes of inappropriate emotional expressions, such as crying or laughing, that do not match the person's mood. The exact cause of PBA is unknown, but it is believed to involve dysfunction in neural circuits and abnormalities in neurotransmitters associated with emotional expression. PBA is often misdiagnosed as depression due to overlapping symptoms, highlighting the importance of recognizing and treating both PBA and potential psychiatric comorbidities.