A Systematic Review of Fragile X–Associated Neuropsychiatric Disorders

Flavell, Joshua; Franklin, Catherine; Nestor, Peter J.

doi:10.1176/appi.neuropsych.21110282

Cited by 4 publications

(1 citation statement)

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“…45,107,108 Neuropsychiatric features include anxiety, depression, disinhibition, impulsivity, mood lability, irritability, apathy, and agitation. [107][108][109][110][111] In a study of 55 carriers with FXTAS, 5 (9%) met the Diagnostic and Statistical Manual (DSM) IV-TR criteria for psychotic disorders, reporting paranoid delusions or hallucinations (visual or olfactory). 112 Accelerated cognitive decline with or without VH has infrequently been described in individuals with gray zone alleles (45)(46)(47)(48)(49)(50)(51)(52)(53)(54) or in rare cases of FXTAS co-occurrence with other neurodegenerative processes, such as AD.…”

Section: Psychotic Symptoms In Manifest Neurodegenerative Diseasesmentioning

confidence: 99%

Advances in the Diagnosis and Management of Psychotic Symptoms in Neurodegenerative Diseases: A Narrative Review

Seritan

2023

J Geriatr Psychiatry Neurol

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Background: Approximately 15% of older adults may experience psychotic phenomena. Primary psychiatric disorders that manifest with psychosis (delusions, hallucinations, and disorganized thought or behavior) account for less than half. Up to 60% of late-life psychotic symptoms are due to systemic medical or neurological conditions, particularly neurodegenerative diseases. A thorough medical workup including laboratory tests, additional procedures if indicated, and neuroimaging studies is recommended. This narrative review summarizes current evidence regarding the epidemiology and phenomenology of psychotic symptoms encountered as part of the neurodegenerative disease continuum (including prodromal and manifest stages). Results: Prodromes are constellations of symptoms that precede the onset of overt neurodegenerative syndromes. Prodromal psychotic features, particularly delusions, have been associated with an increased likelihood of receiving a neurodegenerative disease diagnosis within several years. Prompt prodrome recognition is crucial for early intervention. The management of psychosis associated with neurodegenerative diseases includes behavioral and somatic strategies, although evidence is scarce and mostly limited to case reports, case series, or expert consensus guidelines, with few randomized controlled trials. Conclusion: The complexity of psychotic manifestations warrants management by interprofessional teams that provide coordinated, integrated care.

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