Progressive Supranuclear Palsy (PSP) is a rare neurodegenerative disease that is classified among Parkinson plus syndromes, manifesting itself with behavioral, cognitive and emotional symptoms as well as parkinsonian symptoms such as postural instability, ophthalmoplegia, bradykinesia, rigidity affecting the brain stem, basal ganglia and cerebellum. Although there is sufficient information about the pathological process and clinical presentation of PSP, there is no valid biomarker for diagnosis, clinical findings and neuroimaging are very important in diagnosis, patients often get misdiagnosis at their first application. It has been reported that psychiatric symptoms are common in these individuals due to the involvement of the frontal-subcortical circuits, and therefore patients can get psychiatric diagnoses in the early period. We aimed to present a 72-year-old female patient who was followed up with the diagnosis of major depressive disorder in various centers for about 4 years, who did not benefit from psychiatric treatment, and diagnosed with PSP eventually. We also aimed to emphasize that importance of considering neurodegenerative diseases in differential diagnosis in patients whose depressive symptoms begin at an advanced age, are resistant to treatment and have atypical symptoms such as the presence of accompanying neurological findings, and psychiatric symptoms may be the first symptom of neurodegenerative diseases.
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