The British Journal of Psychiatry (2009) 194: 298-305. doi: 10.1192/bjp.bp.108.057034
© 2009 The Royal College of Psychiatrists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Data supplement
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Related articles in BJP
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Velakoulis, D.
Right arrow Articles by McLean, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Velakoulis, D.
Right arrow Articles by McLean, C.

SPECIAL ARTICLE

Frontotemporal dementia presenting as schizophrenia-like psychosis in young people: clinicopathological series and review of cases

D. Velakoulis, M. Walterfang and R. Mocellin

Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Health, and Melbourne Neuropsychiatry Centre, University of Melbourne

C. Pantelis

Melbourne Neuropsychiatry Centre, University of Melbourne

C. McLean

National Neural Tissue Resource Centre, National Neuroscience Facility, and Anatomical Pathology, Alfred Hospital, Melbourne, Victoria, Australia

Correspondence: Dr Dennis Velakoulis, Neuropsychiatry Unit, Level 2 John Cade Building, Royal Melbourne Hospital, Parkville, Victoria 3052, Australia. Email: dennis.velakoulis{at}mh.org.au

Declaration of interest

None.

Background

Few studies have investigated the relationship between schizophrenia and frontotemporal dementia.

Aims

To investigate this relationship through a clinicopathological investigation of young-onset frontotemporal dementia and a review of the case literature.

Method

Cases of young-onset frontotemporal dementia were identified within the local brain bank. The clinical course and pathological findings were collated. For the literature review, cases of frontotemporal dementia identified through Medline were selected according to defined criteria. The demographic, clinical, pathological and genetic characteristics of cases presenting with a psychotic illness were identified.

Results

In the case series, 5 of 17 patients with frontotemporal dementia had presented with a psychotic illness (schizophrenia/schizoaffective disorder n=4, bipolar disorder n=1) an average of 5 years prior to the dementia diagnosis. Patients with schizophrenia exhibited changes consistent with TDP-43 and ubiquitin-positive frontotemporal dementia. In the cases review, a third of patients aged 30 years or under and a quarter of those aged 40 years or under had been diagnosed with psychosis at presentation.

Conclusions

Patients with young-onset frontotemporal dementia may be diagnosed with a psychotic illness years before the dementia diagnosis is made. These findings have implications for clinicians and for our further understanding of the neurobiology of psychotic illness.


Related articles in BJP:

From the Editor’s desk
Peter Tyrer
BJP 2009 194: 386. [Full Text]  

Highlights of this issue
Kimberlie Dean
BJP 2009 194: A15. [Full Text]