Non-Picks frontotemporal dementia imitating schizophrenia in a 22-year-old man

Stone, Jon; Griffiths, Timothy D.; Rastogi, S; Perry, Richard J.; Cleland, P. G.

doi:10.1007/s00415-003-0989-0

Cited by 21 publications

(19 citation statements)

References 6 publications

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“…Pica is rare in schizophrenia 12 and there is at least one other report of a young patient with pica being diagnosed with schizophrenia but actually having bvFTD. 13 Also unlike patients with schizophrenia, patients with bvFTD often show a qualitative change in the manner of food intake, which can include overstuffing their mouths to the point of gagging, and being unable to stop themselves from eating long after they feel full as long as food remains in front of them. 11 Overeating and weight gain when present in schizophrenia are typically due to physiological side effects from atypical anti-psychotic medications.…”

Section: Discussionmentioning

confidence: 99%

Schizophrenia or Neurodegenerative Disease Prodrome? Outcome of a First Psychotic Episode in a 35-Year-Old Woman

et al. 2012

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Background Patients with early onset neurodegenerative disease can present with a clinical syndrome that overlaps with schizophrenia, and it is not uncommon for these patients to undergo long-term care in psychiatric settings rather than receiving more appropriate care by neurologists specializing in their disease. Case report A 35-year old woman who presented with new-onset delusions, eating abnormalities, disorganized behavior, lack of insight, disinhibition, and stereotypical motor behaviors was diagnosed with schizophrenia and institutionalized. Later she was found to have a MAPT tau S356T mutation and a focal pattern of brain atrophy consistent with frontotemporal dementia (FTD). Conclusion Physicians should be aware of the potential overlap in symptoms and age of onset between some forms of FTD and schizophrenia, and should include FTD in the diagnostic differential for adult patients with new onset, rapidly progressive personality changes or behavioral symptoms such as binge eating, high levels of social disinhibition, or progressive mutism.

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Section: Discussionmentioning

confidence: 99%

Schizophrenia or Neurodegenerative Disease Prodrome? Outcome of a First Psychotic Episode in a 35-Year-Old Woman

et al. 2012

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“…Although FTD may resemble schizophrenia [28][29][30][31] , many reports of FTD patients with delusions or hallucinations probably referred to alternative diagnoses. The original report was Goldstein and Katz's [7] (1937) analysis of the psychopathology of a 56-year-old woman with presumed Pick's disease.…”

Section: Discussionmentioning

confidence: 99%

Psychotic Symptoms in Frontotemporal Dementia: Prevalence and Review

Mendez

Shapira

Woods

et al. 2008

Dement Geriatr Cogn Disord

110

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Background/Aims: Although most patients with frontotemporal dementia (FTD) present with neuropsychiatric symptoms, the frequency of psychotic symptoms is unclear. This study aims to determine the prevalence of psychotic symptoms in a large cohort of well-diagnosed and followed FTD patients compared to age-matched patients with Alzheimer’s disease (AD) and to further review the literature on psychosis in FTD. Methods: Delusions, hallucinations and paranoia were evaluated among 86 patients who met consensus criteria for FTD, had frontotemporal changes on functional neuroimaging and were followed for 2 years. They were compared to 23 patients with early-onset AD on a caregiver-administered psychiatric questionnaire. Results: Among the FTD patients, only 2 (2.3%) had delusions, 1 of whom had paranoid ideation; no FTD patient had hallucinations. This was significantly less than the AD patients, 4 (17.4%) of whom had delusions and paranoia. Other investigations fail to establish a significant association of psychosis with FTD. Conclusions: These findings, and a literature review, indicate that psychotic symptoms are rare in FTD, possibly due to limited temporal-limbic involvement in this disorder.

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“…The clinical presentation of bvFTD has a wide range of symptoms, including prominent neuropsychiatric symptoms that often mimic psychiatric disorders 3,4. Various studies described the overlapping symptoms between bvFTD and psychiatric disorders, resulting in frequent misdiagnoses, with psychosis as one of the most common 5–8…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies on psychotic symptoms in bvFTD were focused only on positive psychotic symptoms (eg, hallucinations, delusions, and paranoia) and found that these psychotic features were present in 10%–32% of bvFTD patients 3,15–17. Even though negative psychotic symptoms and formal thought disorders have led to frequent misdiagnosis of psychosis in bvFTD patients, comprehensive studies on the full spectrum of psychosis in bvFTD are lacking 5,8,18–20. Although the distinction between bvFTD and psychiatric disorders is a major diagnostic dilemma, especially in the early stages of disease,3,5,21 knowledge on psychotic symptoms in bvFTD based on this common broad definition of psychosis cannot be ignored.…”

Section: Introductionmentioning

confidence: 99%

Psychosis in behavioral variant frontotemporal dementia

Gossink¹,

Vijverberg²,

Krudop³

et al. 2017

NDT

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BackgroundDementia is generally characterized by cognitive impairment that can be accompanied by psychotic symptoms; for example, visual hallucinations are a core feature of dementia with Lewy bodies, and delusions are often seen in Alzheimer’s disease. However, for behavioral variant of frontotemporal dementia (bvFTD), studies on the broad spectrum of psychotic symptoms are still lacking. The aim of this study was to systematically and prospectively subtype the wide spectrum of psychotic symptoms in probable and definite bvFTD.MethodsIn this study, a commonly used and validated clinical scale that quantifies the broad spectrum of psychotic symptoms (Positive and Negative Symptom Scale) was used in patients with probable and definite bvFTD (n=22) and with a primary psychiatric disorder (n=35) in a late-onset frontal lobe cohort. Median symptom duration was 2.8 years, and the patients were prospectively followed for 2 years.ResultsIn total, 22.7% of bvFTD patients suffered from delusions, hallucinatory behavior, and suspiciousness, although the majority of the patients exhibited negative psychotic symptoms such as social and emotional withdrawal and blunted affect (95.5%) and formal thought disorders (81.8%). “Difficulty in abstract thinking” and “stereotypical thinking” (formal thought disorders) differentiated bvFTD from psychiatric disorders. The combined predictors difficulty in abstract thinking, stereotypical thinking, “anxiety”, “guilt feelings,” and “tension” explained 75.4% of variance in the diagnosis of bvFTD versus psychiatric diagnoses (P<0.001).ConclusionDelusions, hallucinatory behavior, and suspiciousness were present in one-fifth of bvFTD patients, whereas negative psychotic symptoms such as social and emotional withdrawal, blunted affect, and formal thought disorders were more frequently present. This suggests that negative psychotic symptoms and formal thought disorders have an important role in the psychiatric misdiagnosis in bvFTD; misdiagnosis in bvFTD might be reduced by systematically exploring the broad spectrum of psychiatric symptoms.

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Non-Picks frontotemporal dementia imitating schizophrenia in a 22-year-old man

Cited by 21 publications

References 6 publications

Schizophrenia or Neurodegenerative Disease Prodrome? Outcome of a First Psychotic Episode in a 35-Year-Old Woman

Schizophrenia or Neurodegenerative Disease Prodrome? Outcome of a First Psychotic Episode in a 35-Year-Old Woman

Psychotic Symptoms in Frontotemporal Dementia: Prevalence and Review

Psychosis in behavioral variant frontotemporal dementia

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