Social behaviour vs. psychiatric features of frontotemporal dementia - Clinical report of two cases

Behavioural disturbances are prominent in frontotemporal dementia (FTD), a focal, non-Alzheimer type of dementia. Although most patients with FTD present with socially inappropriate behaviour, compulsive-like acts, poor insight and disinhibition, the presence of psychiatric features including delusions, hallucinations, and paranoia can lead to a misclassification of FTD as psychiatric disorder. In the absence of cognitive deficits non-experts fail to recognize these social changes as dementia symptoms. We report two individuals who met current clinical criteria for behavioural or frontal variant FTD (bv-FTD), with the aim of distinguishing between psychotic symptoms and the often bizarre personality and behaviour change found in FTD. Also we review the literature on the noncognitive neuropsyhiatric manifestation of this disorder. Clinical findings presented, and a literature review, indicate that psychotic symptoms are rare in FTD. Better awareness of behavioural symptoms in clinical practice is necessary in order to avoid misdiagnosis of FTD as psychiatric disorder.