Neuropsychiatric Disease and Treatment (Nov 2022)
Major Depression and Onset of Frontotemporal Dementia
Abstract
Małgorzata Urban-Kowalczyk,1 Magdalena Kasjaniuk,2 Janusz Śmigielski,3 Magdalena Kotlicka-Antczak1 1Department of Affective and Psychotic Disorders, Medical University of Lodz, Lodz, Poland; 2Central Teaching Hospital of the Medical University of Lodz, Lodz, Poland; 3Department of Health Sciences, State University of Applied Sciences in Konin, Konin, PolandCorrespondence: Małgorzata Urban-Kowalczyk, Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, Lodz, 92-216, Poland, Tel +48 42 675 73 71, Fax +48 42 675 74 03, Email [email protected]: Frontotemporal dementia (FTD) is still a clinical challenge with the highest rate of misdiagnosis and poor outcome. The pathogenetic relationship between depression and neurodegeneration remains unclear. This study evaluated depression prevalence before FTD diagnosis.Patients and Methods: The aim was to assess the prevalence and impact of depression on FTD diagnostic process. The clinical characteristics of 72 patients hospitalized in Department of Affective and Psychotic Disorders Medical University of Lodz between 2010 and 2020 with final diagnosis FTD were analyzed. The data referring to first psychiatric diagnosis, time from first psychopathological symptoms to clarification of FTD diagnosis were collected. The patients who did not undergo full neuropsychiatric verification were excluded from the analysis.Results: About 69% of patients had other concomitant diagnosis of mental disorders which was made prior to FTD diagnosis. Among this subsample, 71% revealed depression diagnosis with at least moderate severity. The patients whose first diagnosis was psychotic depression revealed the longest period from the appearance of the first psychopathological symptoms to the diagnosis of FTD in comparison to the subsample with other psychiatric diagnosis (p=0.034; mean 4.33± 3.28 years vs mean 2.68± 1.39 years).Conclusion: The severe depressive symptoms in older age may reflect the development of neurodegeneration before full-blown frontotemporal dementia symptomatology. We hypothesized that psychotic depression is a predictor of FTD. Further investigations in this field are required.Keywords: affective disorders, psychosis, neurodegeneration, cognitive disorders, frontotemporal dementia
