Psychotic symptoms in frontotemporal dementia: prevalence and review.
OBJECTIVE
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.
Mendez
Mario F
MF
Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, Calif., USA. mmendez@ucla.edu
Shapira
Jill S
JS
Woods
Rochelle J
RJ
Licht
Eliot A
EA
Saul
Ronald E
RE
D000544:Alzheimer Disease / Q000453:epidemiology / Q000523:psychology; D003702:Delusions / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003704:Dementia / Q000453:epidemiology / Q000473:pathology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010259:Paranoid Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology