C. Fones et Wf. Tsoi, POLYCYTHEMIA RUBRA VERA PRESENTING WITH DEPRESSION - RECOGNIZING THE SYNDROME ABULIA, British journal of clinical practice, 49(2), 1995, pp. 97-99
A patient with polycythaemia rubra vera is described, presenting prima
rily with symptoms attributed to depression. While in the ward she dev
eloped a stroke, confirmed on CT scan of the head. Venesection alone p
roduced marked improvement in her neurological and psychiatric symptom
s. The clinical picture corresponds most accurately to the neurologica
l syndrome of abulia, which is an important differential diagnosis of
depression with psychomotor retardation. The pathophysiology of impair
ed cerebral blood flow causing neuropsychiatric symptoms in polycythae
mia is discussed.