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An Evidence-Based Review of the Psychopathology of Frontotemporal Dementia: A Report of the ANPA Committee on Research

Received April 25, 2007; revised and accepted August 14, 2007. Dr. Mendez is affiliated with the Departments of Neurology and Psychiatry and Biobehavioral Sciences at UCLA and the Neurobehavior Unit at the VA Greater Los Angeles Healthcare in Los Angeles, Calif.; Dr. Lauterbach is affiliated with the Department of Psychiatry and Behavioral Science at Mercer University in Macon, Ga.; Dr. Sampson is affiliated with the Department of Psychiatry at the Mayo Clinic in Rochester, Minn. Address correspondence to M.F. Mendez, Neurobehavior Unit (116AF), VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073; mmendez{at}ucla.edu (e-mail).

The Committee on Research of the American Neuropsychiatric Association conducted a review of the noncognitive neuropsychiatric manifestations of frontotemporal dementia. The Committee on Research searched reviews and several online databases for all pertinent publications. Single case reports without pathology were excluded, except for psychosis, where single cases made up much of the literature. The strongest evidence supports an association of frontotemporal dementia with the following behaviors: apathy-abulia; disinhibition-impulsivity; loss of insight and self-referential behavior; decreased emotion and empathy; violation of social and moral norms; changes in dietary or eating behavior; and repetitive behaviors. Frontotemporal dementia is less frequently associated with anxiety and mood disorders, which may be a prodrome or risk factor, and rarely presents with delusions or hallucinations. The results of this review highlight the distinct neuropsychiatric manifestations of frontotemporal dementia and the need to reconsider the current diagnostic criteria for this disorder.

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