A Case of Frontotemporal Dementia in the Shadow of Schizophrenia Diagnosis

Abstract

Frontotemporal dementia (FTD), is the second most frequent type of early onset dementia, constituting about 13% of all dementia cases (1,2). Typical age of onset is 45-60 years of life, it is more common in men and about 50% of the patients have positive family history (3). These cases are misdiagnosed more often than late-onset dementias; they mostly emerge with neuropsychiatric presentation. Clinical presentation often includes deficiency in performing daily activities, decrease in self-care, decrease in human relations, and change in eating habits. Disorientation, distractibility, disinhibition, perseverations, compulsive and stereotypical behaviors, and lack of insight can be observed in the psychiatric examination (4,5).Imaging studies will depict medial and anterior temporal lobe degeneration (6). Different psychiatric symptoms can be seen in FTD cases related to the affected neuroanatomical regions. Personality and behavioral changes, apathy, and psychotic symptoms prevail in frontal region involvement, whereas, decrease in emotional processing, interpersonal coldness, and hypomania-like behavior prevail when temporal region is affected (7). The frequency of delusions is 14%, and most common are paranoid and somatic delusions (8). FTD patients can be misdiagnosed as having a psychiatric disorder because of the symptoms that could be seen in schizophrenia such as obsessional thoughts, typical or bizarre compulsions, and delusions in the early stages and; mutism, inappropriate social behavior, impaired social relationships, lack of insight, stereotyped behavior and speech, in the late stages (9).Our case is a 47-year-old male, married, college graduate, and had resigned from his job as a civil servant at a library. The patient was admitted to the psychiatric outpatient clinic for the first time 10 years ago with complaints of unhappiness, reluctance, and weakness. He was hospitalized with the diagnosis of depression, received antidepressant treatment and was discharged after recovery. Six months after being discharged, the patient was once again followed up with the diagnosis of psychotic disorder when he had the complaints of sadness, unhappiness, skepticism, hearing voices that others did not hear while falling asleep, problems at work and with family members, and difficulties in working. The patient who showed partial improvement How to cite this article: Arslan S, Yucens B, Celebi C. A Case of frontotemporal dementia in the shadow of schizophrenia.