[Frontotemporal dementia diagnoses within the psychiatric practice: pitfalls and practical tools]

Area of Science:

• Neuroscience
• Psychiatry
• Neurology

Background:

• Behavioral variant of frontotemporal dementia (bvFTD) presents symptoms similar to primary psychiatric disorders.
• Non-neurodegenerative conditions can mimic bvFTD, complicating diagnosis.

Purpose of the Study:

• To provide psychiatrists with clinical tools for diagnosing or ruling out bvFTD.
• To differentiate bvFTD from psychiatric disorders and bvFTD-phenocopy syndromes.

Main Methods:

• Prospective cohort study comparing bvFTD patients and primary psychiatric patients.
• Analysis of clinical criteria, neuroimaging (atrophy, hypometabolism), and specific behavioral symptoms.
• Review of findings within the context of international literature.

Main Results:

• Frontotemporal atrophy on imaging is indicative of bvFTD.
• Clinical criteria alone, with or without hypometabolism, can be present in psychiatric disorders or bvFTD-phenocopy syndrome.
• Symptoms such as stereotypy, hyperorality, low depressive symptoms, impaired social cognition, and absent insight increase bvFTD probability.

Conclusions:

• bvFTD diagnosis requires a multidisciplinary approach.
• Reserve is advised when diagnosing bvFTD without confirmed atrophy or genetic testing.
• Thorough evaluation for psychiatric etiologies is essential when neurodegenerative markers are absent.