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Published on: March 2, 2019
Psychiatric Screening Measures in Behavioral Variant Frontotemporal Dementia
Peter S Pressman1, Joie Molden1, Hal S Wortzel1
1Behavioral Neurology Section, Department of Neurology (Pressman, Wortzel, Woodcock, Filley, Arciniegas), and Department of Psychiatry (Wortzel, Filley, Arciniegas), University of Colorado School of Medicine, Aurora; Departments of Neurosurgery (Molden) and Psychiatry (Plys) and the Marcus Institute for Brain Health (Filley, Arciniegas), University of Colorado Anschutz Medical Campus, Aurora; Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora (Wortzel); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas).
Behavioral variant frontotemporal dementia (bvFTD) often screens positive for psychiatric disorders like autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) due to common screening tools. Further research is needed to differentiate bvFTD from primary psychiatric conditions.
Area of Science:
- Neuroscience
- Psychiatry
Background:
- Behavioral variant frontotemporal dementia (bvFTD) is frequently misdiagnosed as primary psychiatric disorders, including major depressive disorder, bipolar disorder, anxiety disorders, autism spectrum disorder (ASD), and attention-deficit hyperactivity disorder (ADHD).
- Nonspecialists often employ screening tools for psychiatric conditions during initial assessments of individuals with bvFTD.
Purpose of the Study:
- To evaluate how bvFTD manifests in screening surveys designed for primary psychiatric disorders.
- To assess the utility of established screening measures in identifying bvFTD.
Main Methods:
- Twenty-seven patients with bvFTD and their caregivers completed questionnaires including the Mood Disorder Questionnaire (MDQ), PHQ-9, GAD-7, Adult ADHD Self-Report Scale, Ritvo Autism and Asperger Diagnostic Scale, and Neuropsychiatric Inventory Questionnaire.
- Established cutoff scores were used to define positive screens for psychiatric disorders. Individual questions were analyzed for granular characterization of bvFTD symptoms.
Main Results:
- A significant percentage of bvFTD patients screened positive: 89% for ASD, 54% for ADHD, and 15% for bipolar disorder.
- Depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7) were endorsed by 57% and 43% of respondents, respectively.
- Hyperactivity or hypersensitivity symptoms were infrequently reported by bvFTD patients.
Conclusions:
- Using standard cutoff scores on psychiatric screening measures can lead to a high rate of false positives in individuals with bvFTD.
- Further investigation is required to identify specific screening questions that can effectively differentiate bvFTD from primary psychiatric disorders.
