Table 3.
Sample of DSM-compatible diagnoses assigned to patients who were subsequently found to have possible, probable and definitive bvFTD
| Early psychiatric disorders in patients later diagnosed with definitive bvFTD (via neuropathological or genetic data) | ||||||||
|---|---|---|---|---|---|---|---|---|
| Psychiatric disorder (per DSM criteria) |
Age at onset of psychiatric disorder (in years) and sex |
Main psychiatric manifestations |
Reported psychiatric management |
Functional status | Age at which bvFTD was suspected (in years) |
Reported brain imaging findings; time between psychiatric disorder and first reported imaging |
Disease duration, including psychiatric stage (in years) |
Genetic (premortem) or neuropathological (postmortem or brain biopsy) diagnosis |
| OCD | 34 F51 | Fear of contamination and compulsive hand washing |
Antipsychotics, TCA, SSRIs, lithrium, carbamazepine, ECT |
Worked as a teacher for 8 months after OCD diagnosis |
36 | Bilateral caudate head atrophy and frontal lobe atrophy; 8 months |
5 | Pick’s disease (FTLD-τ) |
| Bipolar disorder | 42 M53 | Mania and hypomania | Lithium and haloperidol | Worked as a teacher until age 57 |
64 | Bilateral frontotemporal atrophy, frontotemporal hypoperfusion (SPECT); 22 years |
The patient was alive at time of case publication. |
C9ORF72 mutation carrier |
| Schizophrenia | 25 F54 | Sudden personality change at age 25 followed by psychotic changes beginning at age 49 |
Antipsychotics | Worked in a factory until age 49 |
65 | Frontotemporal atrophy; 40 years |
46 | Pick’s disease (FTLD-τ) |
| 35 F55 | Changes in personality and behaviour, delusions |
Antipsychotics, SSRIs, benzodiazepines |
NA | 48 | Bifrontal atrophy; 13 years | The patient was alive at time of case publication |
MAPT mutation carrier | |
| 22 M26 | Personality and behavioural changes, psychosis |
Antipsychotics, sodium valproate, benzodiazepines, oral steroids, ECT |
Worked as a painter until age 22 |
Bilateral frontotemporal atrophy; 2 years |
The patient was alive at time of case publication |
FTLD neuropathological changes per brain biopsy (unclear subtype) |
||
| Heterosexual paedophilia |
48 M56 | Sexual arousals and urges towards his 9 year-old daughter |
Antipsychotics and SSRIs | NA | 55 | Frontal lobe atrophy, bilateral frontal hypoperfusion; 1 year |
The patient was alive at time of case publication |
GRN mutation carrier |
| Early psychiatric disorders in patients who were later diagnosed with probable bvFTD (based on clinical syndrome and imaging findings) | ||||||||
| Psychiatric disorder (per DSM criteria) |
Age at onset of psychiatric disorder (in years) |
Main psychiatric manifestations |
Reported psychiatric management |
Functional status | Age at which bvFTD was suspected (in years) |
Reported brain imaging findings; time between psychiatric disorder and first reported imaging |
Disease duration, including psychiatric stage (in years) | |
| Bipolar disorder | 33 F57 | Mania, hypomania, and delusions |
Lithium, valproic acid, antipsychotics, SSRIs, carbamazepine, ECT |
NA | 68 | Bifrontal atrophy, bilateral frontal and temporal lobe hypoperfusion (SPECT); 35 years |
The patient was alive at time of case publication | |
| OCD | 30 F58 | Fears of contamination, compulsive checking and cleaning |
Antipsychotics, SSRIs, sodium valproate |
NA | 57 | Bifrontal atrophy, bifrontal hypoperfusion (SPECT); 27 years |
The patient was alive at time of case publication | |
| 40 M59 | Fears of contamination, compulsive checking and hand washing |
SSRIs | NA | 57 | Frontal lobe atrophy, frontal lobe hypoperfusion (SPECT); 17 years |
The patient was alive at time of case publication | ||
| Panic disorder | 44 F60 | New onset daily panic attacks |
NA | NA | 48 | Bifrontal atrophy, frontal lobe hypoperfusion; 4 years |
The patient was alive at time of case publication | |
| Pathological gambling | 67 F61 | Daily gambling despite ruining personal and family finances |
SSRIs and carbamazepine | NA | 69 | Bifrontal atrophy, bilateral frontal and temporal lobe hypoperfusion (SPECT); 2 years |
The patient was alive at time of case publication | |
| OCD, psychosis | 30 F62 | Compulsive hand-washing, cleaning rituals |
SSRI’s, Antipsychotics and ECT |
Unable to keep a steady job |
38 | Frontotemporal atrophy (dates unclear) |
The patient was alive at time of case publication | |
| Major depressive disorder |
55 M49 | Sadness, decreased emotional responsiveness, decreased concentration |
SSRIs | Continued to work until FTD diagnosis |
57 | ‘Normal’ imaging, right frontal lobe hypoperfusion (SPECT) (dates unclear) |
The patient was alive at time of case publication | |
bvFTD, behavioural variant frontotemporal dementia; DSM, Diagnostic and Statistical Manual of Mental Disorders; ECT, electroconvulsive therapy; FTLD, frontotemporal lobar degeneration; GRN, granulin; MAPT, microtubule-associated protein τ; NA not applicable; OCD, obsessive-compulsive disorder; SPECT, single-photon emission CT; SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant.