Frontal variant of frontotemporal dementia: a cross-sectional and longitudinal study of neuropsychiatric features

Background. The term frontotemporal dementia (FTD) covers both the temporal and frontal presentations of this condition. The frontal variant (fv) pres ents with insidious changes in personality and behaviour, with neuropsychol ogical evidence of disproportionate frontal dysfunction. Although psychiatr ic features are well. recognized, there is little systematic data examining the mental state using assessment instruments and no reported studies of t he longitudinal progress and assessment. Methods. Fifteen patients with a diagnosis of FTD(fv) were assessed using t he Comprehensive Psychiatric Rating Scale (CPRS). A subgroup of five patien ts were reassessed annually using the same instrument, generating data over a 3-year period. Results. At initial assessment a third of 15 patients had no psychiatric sy mptoms to report. Three patients reported symptoms of sadness, but only one patient met criteria for DSM-TV major depressive episode. One patient expe rienced symptoms of elation, but did not meet criteria for manic episode, w hile two patients had hypochondriacal complaints but did not meet DSM-IV cr iteria for hypochondriasis. One of these patients also experienced the comp ulsion to count but did not meet criteria for obsessive compulsive disorder . The objective mental state was, on the whole, not congruent with the repo rted symptoms. Five patients assessed over a 3-year period showed no progre ssion of their subjectively reported symptoms. Conclusion. Psychiatric symptoms although often present were characterized by their shallowness, lack of elaboration and non-development over time.