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Psychiatric misdiagnosis in behavioral variant frontotemporal dementia in Cali, Colombia
Author(s) -
ZapataRestrepo Lina Maria,
Possin Kate,
Rivas Juan Carlos,
Miranda Carlos,
Miller Bruce L.,
Allen Isabel Elaine
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.051695
Subject(s) - apathy , frontotemporal dementia , psychiatry , dementia , medical diagnosis , medicine , anxiety , depression (economics) , population , disease , clinical psychology , cognition , pathology , environmental health , economics , macroeconomics
Background Psychiatric manifestations are common in the behavioral variant of frontotemporal dementia (bvFTD) with many patients misclassified with other psychiatric diagnoses. In this study, we described the initial neuropsychiatric symptoms and the psychiatric misdiagnoses in a diverse population of patients with probable bvFTD seen at a psychiatric public hospital in Colombia. Methods We retrospectively reviewed the medical records of 28 patients who met diagnostic criteria for probable bvFTD based on a multidisciplinary evaluation. Neuropsychiatric symptoms were rated using the NPI. Initial psychiatric diagnoses were made using the DSM‐V. The bvFTD diagnostic criteria of the international consortium were used. Stata 16.1 and SPSS 27.0 were used for the statistical analysis. Results Using the NPI, we found that the most common symptoms were apathy in both genders. Delusions were present in 60.7% and hallucinations in 39.2% of the sample. 71.4% of the patients were misdiagnosed with psychiatric disease and not with dementia. In women, the most frequent psychiatric diagnoses were depression (26.3%), and bipolar disorder (26.3%), while in men it was anxiety disorders (33.3%) and psychotic disorders (22.2%). Conclusion Psychotic symptoms were higher in this sample than in previous studies. The presence of psychiatric symptoms and their possible overlap in patients with bvFTD make differential diagnosis difficult. The misdiagnosis could be related to factors such as a lack of knowledge about this type of dementia in the medical community. In the future, the implementation of specific biomarkers and genetic testing will help to improve the diagnosis of bvFTD.