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Psychotic symptoms in frontotemporal dementia: prevalence and review
Mario F Mendez1, Jill S Shapira, Rochelle J Woods
1Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, Calif., USA. mmendez@ucla.edu
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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