Psychotic symptoms in frontotemporal dementia: a diagnostic dilemma?
Landqvist, Maria LU ; Gustafson, Lars LU ; Passant, Ulla LU and Englund, Elisabet LU
(2015)
In International Psychogeriatrics
27(4).
p.531-539
- Abstract
- ABSTRACT Background: Frontotemporal dementia (FTD) constitutes a spectrum of neurodegenerative disorders associated with degeneration of, predominantly, the frontal and temporal lobes. The clinical heterogeneity is evident, and early diagnosis is a challenge. The primary objectives were to characterize psychotic symptoms, initial clinical diagnoses and family history in neuropathologically verified FTD-patients and to analyze possible correlations with different neuropathological findings. Methods: The medical records of 97 consecutive patients with a neuropathological diagnosis of frontotemporal lobar degeneration (FTLD) were reevaluated. Psychotic symptoms (hallucinations, delusions, paranoid ideas), initial diagnosis and family history... (More)
- ABSTRACT Background: Frontotemporal dementia (FTD) constitutes a spectrum of neurodegenerative disorders associated with degeneration of, predominantly, the frontal and temporal lobes. The clinical heterogeneity is evident, and early diagnosis is a challenge. The primary objectives were to characterize psychotic symptoms, initial clinical diagnoses and family history in neuropathologically verified FTD-patients and to analyze possible correlations with different neuropathological findings. Methods: The medical records of 97 consecutive patients with a neuropathological diagnosis of frontotemporal lobar degeneration (FTLD) were reevaluated. Psychotic symptoms (hallucinations, delusions, paranoid ideas), initial diagnosis and family history for psychiatric disorders were analyzed. Results: Psychotic symptoms were present in 31 patients (32%). There were no significant differences in age at onset, disease duration or gender between patients with and without psychotic symptoms. Paranoid ideas were seen in 20.6%, and hallucinations and delusions in 17.5% in equal measure. Apart from a strong correlation between psychotic symptoms and predominantly right-sided brain degeneration, the majority of patients (77.4%) were tau-negative. Only 14.4% of the patients were initially diagnosed as FTD, while other types of dementia were seen in 34%, other psychiatric disorders in 42%, and 9.2% with other cognitive/neurological disorders. The patients who were initially diagnosed with a psychiatric disorder were significantly younger than the patients with other initial clinical diagnoses. A positive heredity for dementia or other psychiatric disorder was seen in 42% and 26% of the patients respectively. Conclusions: Psychotic symptoms, not covered by current diagnostic criteria, are common and may lead to clinical misdiagnosis in FTD. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4908772
- author
- Landqvist, Maria
LU
; Gustafson, Lars
LU
; Passant, Ulla
LU
and Englund, Elisabet
LU
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- in
- International Psychogeriatrics
- volume
- 27
- issue
- 4
- pages
- 531 - 539
- publisher
- Cambridge University Press
- external identifiers
-
- pmid:25486967
- wos:000351058200003
- scopus:84924270172
- pmid:25486967
- ISSN
- 1741-203X
- DOI
- 10.1017/S1041610214002580
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pathology, (Lund) (013030000), Department of Psychogeriatrics (013304000)
- id
- ca9cde29-3814-4d81-a2db-c5fa6df4bcff (old id 4908772)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/25486967?dopt=Abstract
- date added to LUP
- 2016-04-01 10:00:44
- date last changed
- 2022-04-12 01:03:53
@article{ca9cde29-3814-4d81-a2db-c5fa6df4bcff,
abstract = {{ABSTRACT Background: Frontotemporal dementia (FTD) constitutes a spectrum of neurodegenerative disorders associated with degeneration of, predominantly, the frontal and temporal lobes. The clinical heterogeneity is evident, and early diagnosis is a challenge. The primary objectives were to characterize psychotic symptoms, initial clinical diagnoses and family history in neuropathologically verified FTD-patients and to analyze possible correlations with different neuropathological findings. Methods: The medical records of 97 consecutive patients with a neuropathological diagnosis of frontotemporal lobar degeneration (FTLD) were reevaluated. Psychotic symptoms (hallucinations, delusions, paranoid ideas), initial diagnosis and family history for psychiatric disorders were analyzed. Results: Psychotic symptoms were present in 31 patients (32%). There were no significant differences in age at onset, disease duration or gender between patients with and without psychotic symptoms. Paranoid ideas were seen in 20.6%, and hallucinations and delusions in 17.5% in equal measure. Apart from a strong correlation between psychotic symptoms and predominantly right-sided brain degeneration, the majority of patients (77.4%) were tau-negative. Only 14.4% of the patients were initially diagnosed as FTD, while other types of dementia were seen in 34%, other psychiatric disorders in 42%, and 9.2% with other cognitive/neurological disorders. The patients who were initially diagnosed with a psychiatric disorder were significantly younger than the patients with other initial clinical diagnoses. A positive heredity for dementia or other psychiatric disorder was seen in 42% and 26% of the patients respectively. Conclusions: Psychotic symptoms, not covered by current diagnostic criteria, are common and may lead to clinical misdiagnosis in FTD.}},
author = {{Landqvist, Maria and Gustafson, Lars and Passant, Ulla and Englund, Elisabet}},
issn = {{1741-203X}},
language = {{eng}},
number = {{4}},
pages = {{531--539}},
publisher = {{Cambridge University Press}},
series = {{International Psychogeriatrics}},
title = {{Psychotic symptoms in frontotemporal dementia: a diagnostic dilemma?}},
url = {{http://dx.doi.org/10.1017/S1041610214002580}},
doi = {{10.1017/S1041610214002580}},
volume = {{27}},
year = {{2015}},
}