Psychosis in behavioral variant frontotemporal dementia

Flora T Gossink,1,2 Everard GB Vijverberg,2,3 Welmoed Krudop,2 Philip Scheltens,2 Max L Stek,1 Yolande AL Pijnenburg,1,2 Annemiek Dols1,2 1Department of Old Age Psychiatry, GGZinGeest, 2Alzheimer Center & Department of Neurology, VU University Medical Center, Amsterdam, 3Department of Neuro...

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Autores principales:	Gossink FT, Vijverberg EGB, Krudop W, Scheltens P, Stek ML, Pijnenburg YAL, Dols A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	frontotemporal dementia psychosis schizophrenia formal thought disorders Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/3cb8b3cebaf141cc95e0ba59c2813399
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spelling	oai:doaj.org-article:3cb8b3cebaf141cc95e0ba59c28133992021-12-02T00:29:48ZPsychosis in behavioral variant frontotemporal dementia1178-2021https://doaj.org/article/3cb8b3cebaf141cc95e0ba59c28133992017-04-01T00:00:00Zhttps://www.dovepress.com/psychosis-in-behavioral-variant-frontotemporal-dementia-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Flora T Gossink,1,2 Everard GB Vijverberg,2,3 Welmoed Krudop,2 Philip Scheltens,2 Max L Stek,1 Yolande AL Pijnenburg,1,2 Annemiek Dols1,2 1Department of Old Age Psychiatry, GGZinGeest, 2Alzheimer Center & Department of Neurology, VU University Medical Center, Amsterdam, 3Department of Neurology, HagaZiekenhuis, The Hague, the Netherlands Background: Dementia 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.Methods: In 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.Results: In 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).Conclusion: Delusions, 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. Keywords: frontotemporal dementia, psychosis, schizophrenia, formal thought disorders Gossink FTVijverberg EGBKrudop WScheltens PStek MLPijnenburg YALDols ADove Medical Pressarticlefrontotemporal dementiapsychosisschizophreniaformal thought disordersNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 1099-1106 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	frontotemporal dementia psychosis schizophrenia formal thought disorders Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	frontotemporal dementia psychosis schizophrenia formal thought disorders Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Gossink FT Vijverberg EGB Krudop W Scheltens P Stek ML Pijnenburg YAL Dols A Psychosis in behavioral variant frontotemporal dementia
description	Flora T Gossink,1,2 Everard GB Vijverberg,2,3 Welmoed Krudop,2 Philip Scheltens,2 Max L Stek,1 Yolande AL Pijnenburg,1,2 Annemiek Dols1,2 1Department of Old Age Psychiatry, GGZinGeest, 2Alzheimer Center & Department of Neurology, VU University Medical Center, Amsterdam, 3Department of Neurology, HagaZiekenhuis, The Hague, the Netherlands Background: Dementia 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.Methods: In 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.Results: In 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).Conclusion: Delusions, 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. Keywords: frontotemporal dementia, psychosis, schizophrenia, formal thought disorders
format	article
author	Gossink FT Vijverberg EGB Krudop W Scheltens P Stek ML Pijnenburg YAL Dols A
author_facet	Gossink FT Vijverberg EGB Krudop W Scheltens P Stek ML Pijnenburg YAL Dols A
author_sort	Gossink FT
title	Psychosis in behavioral variant frontotemporal dementia
title_short	Psychosis in behavioral variant frontotemporal dementia
title_full	Psychosis in behavioral variant frontotemporal dementia
title_fullStr	Psychosis in behavioral variant frontotemporal dementia
title_full_unstemmed	Psychosis in behavioral variant frontotemporal dementia
title_sort	psychosis in behavioral variant frontotemporal dementia
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/3cb8b3cebaf141cc95e0ba59c2813399
work_keys_str_mv	AT gossinkft psychosisinbehavioralvariantfrontotemporaldementia AT vijverbergegb psychosisinbehavioralvariantfrontotemporaldementia AT krudopw psychosisinbehavioralvariantfrontotemporaldementia AT scheltensp psychosisinbehavioralvariantfrontotemporaldementia AT stekml psychosisinbehavioralvariantfrontotemporaldementia AT pijnenburgyal psychosisinbehavioralvariantfrontotemporaldementia AT dolsa psychosisinbehavioralvariantfrontotemporaldementia
_version_	1718403669483847680

Psychosis in behavioral variant frontotemporal dementia

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