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Three case histories consider dementia vs depressive pseudo-dementia, two the possibility of a cerebral vasculitis in patients with auto-immune conditions, and two whether the patient had a \u201ctype\u201d of depression likely to benefit from a course of ECT. Published studies reviewing the utility of SPECT in dementia, depression, depressive \u201cpseudodementia\u201d and cerebral lupus are considered. 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