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When depression envelops frontotemporal dementia: The differential diagnostic frame through a case report

Published online by Cambridge University Press:  01 September 2022

U. Altunoz ,
J. Menstell  and
M. Ziegenbein
U. Altunoz*
Affiliation:
Wahrendorff Clinic, Centre Of Transcultural Psychiatry & Psychotherapy, Sehnde, Germany Hannover Medical School, Research Group For Social And Transcultural Psychiatry & Psychotherapy, Hannover, Germany
J. Menstell
Affiliation:
Wahrendorff Clinic, Centre Of Transcultural Psychiatry & Psychotherapy, Sehnde, Germany
M. Ziegenbein
Affiliation:
Wahrendorff Clinic, Department Of Psychiatry & Psychotherapy, Sehnde, Germany
*
*Corresponding author.

Abstract

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Introduction

Frontotemporal dementia (FTD) is common in presenile population. The overlapping symptoms with other psychiatric disorders can lead to wrong/late diagnosis which cause delays/difficulties regarding case-management. Especially, long-standing and/or late-onset depression can descriptively envelop bvFTD (behavioral-variant) and leads to unnecessary treatments and increased distress. It’s important to implement a descriptive diagnostic algorithm which will help clinicians to distinguish the phenomenology of these disorders.

Objectives

This presentation aims to call attention of the clinicians/researchers to an elaborated effort concerning differential diagnosis of two common disorders with overlapping features through a case-study of a 59-year-old male patient.

Methods

One case from an inpatient unit of a psychiatric clinic in Lower Saxony, Germany will be reported.

Results

Case: The patient was referred to our acute-psychiatric-ward from the day-clinic-unit because of treatment-resistant, severe and long-lasting depressive symptoms. He was depressed, desperate, hopeless, listless and had suicidal thoughts. During the first days of treatment, symptoms like apathy, bad hygiene, weird eating-behavior, urinary incontinence, lack of empathy, language disorders and other behavioral symptoms were evident. Brain-MRI yielded frontotemporal lobar atrophy. Trail-Making-Test and Frontal-Assessment-Battery showed pronounced impairment of executive functions. Mini mental state examination and DemTect yielded light to moderate memory dysfunction. Diagnostic Criteria for Probable bvFTD (International-Consensus-Criteria) were fulfilled.

Conclusions

The diagnosis of bvFTD enabled a rapid assignment of a legal representative and relieved the long-lasting discomfort of the patient and his family that was caused by multiple unsuccessful treatment trials against depression. The differential diagnostic frame between bvFTD and depression will be discussed in view of the current literature.

Disclosure

No significant relationships.

Keywords

differential diagnosisDepressionfrontotemporal dementia
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S648 - S649
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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