title: Formal Psychiatric Disorders are not Overrepresented in Behavioral Variant Frontotemporal Dementia.
abstract: While psychiatric misdiagnosis is well-known in behavioral variant frontotemporal dementia (bvFTD), a systematic evaluation of standardized criteria for psychiatric disorders in bvFTD is still missing. Our aim was to define frequency and character of DSM-IV psychiatric disorders among patients with probable and definite bvFTD compared to possible bvFTD, other neurodegenerative diseases, and psychiatric diagnoses, using MINI-International Neuropsychiatric Interview. We additionally compared psychiatric prodromes between these groups. Subjects were participants of the late-onset frontal lobe (LOF) study, a longitudinal multicenter study. In each patient, after baseline diagnostic procedure, a neurologist and geriatric psychiatrist made a joint clinical diagnosis. Independently, a structured diagnostic interview according to DSM-IV and ICD-10 criteria (MINI-Plus) was performed by a trained professional blinded to clinical diagnosis. Out of 91 patients, 23 with probable and definite bvFTD, 3 with possible bvFTD, 25 with a non bvFTD neurodegenerative disease, and 40 with a clinical psychiatric diagnosis were included. Overall frequency of formal current and past psychiatric disorders in probable and definite bvFTD (21.7% current, 8.7% past) did not differ from other neurodegenerative diseases (12.0% current, 16.0% past) or possible bvFTD (66.7% current, 66.7% past), but was less than in patients with a clinical psychiatric diagnosis (57.5% current, 62.5% past; p <  0.01). In probable and definite bvFTD unipolar mood disorders were most common. Formally diagnosed psychiatric disorders are not overrepresented in probable bvFTD, suggesting that psychiatric misdiagnosis in bvFTD can be reduced by strictly applying diagnostic criteria. In suspected bvFTD close collaboration between neurologists and psychiatrists will advance diagnostics and subsequent treatment.
authors.affiliation: Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, The Netherlands.|Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Flora T
authors.initials: FT
authors.lastname: Gossink
authors.affiliation: Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, The Netherlands.|Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Annemieke
authors.initials: A
authors.lastname: Dols
authors.affiliation: Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Welmoed A
authors.initials: WA
authors.lastname: Krudop
authors.affiliation: Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Sietske A
authors.initials: SA
authors.lastname: Sikkes
authors.affiliation: Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Cora J
authors.initials: CJ
authors.lastname: Kerssens
authors.affiliation: Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Niels D
authors.initials: ND
authors.lastname: Prins
authors.affiliation: Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.affiliation: Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Max L
authors.initials: ML
authors.lastname: Stek
authors.affiliation: Department of Old Age Psychiatry, GGZinGeest/VU University Medical Center, Amsterdam, The Netherlands.|Alzheimer Centre & Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Yolande A L
authors.initials: YA
authors.lastname: Pijnenburg
mesh_terms: D000368:Aged; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales
keywords: Behavior; DSMIV criteria; ICD-10 criteria; behavioral variant frontotemporal dementia; misdiagnosis; neurology; psychiatric disorders; psychiatry