Psychiatric symptoms in preclinical behavioural-variant frontotemporal dementia in MAPT mutation carriers

J Neurol Neurosurg Psychiatry. 2018 May;89(5):449-455. doi: 10.1136/jnnp-2017-317263. Epub 2018 Jan 20.


Objective: To characterise psychiatric symptoms in preclinical and early behavioural-variant frontotemporal dementia (bvFTD), a neurodegenerative disorder whose symptoms overlap with and are often mistaken for psychiatric illness.

Methods: The present study reports findings from a systematic, global, prospective evaluation of psychiatric symptoms in 12 preclinical carriers of pathogenic MAPT mutations, not yet meeting bvFTD diagnostic criteria, and 46 familial non-carrier controls. Current psychiatric symptoms, informant-reported symptoms and lifetime prevalence of psychiatric disorders were assessed with The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the Neuropsychiatric Inventory Questionnaire. Fisher exact test was used to compare carriers and non-carriers' lifetime prevalence of six DSM-IV disorders: major depressive disorder, panic attacks, alcohol abuse, generalised anxiety disorder, panic disorder, and depressive disorder not otherwise specified. Other DSM-IV disorders had insufficient prevalence across our sample for between-group comparisons, but are reported.

Results: Non-carriers had greater prevalence of mood and anxiety disorders than has been reported for a general reference population. Preclinical carriers had lower lifetime prevalence of mood and anxiety disorders than non-carriers, except for depressive disorder not otherwise specified, an atypical syndrome comprising clinically significant depressive symptoms which fail to meet criteria for major depressive disorder.

Conclusion: Findings suggest that early psychiatric symptoms of emergent bvFTD may manifest as emotional blunting or mood changes not cleanly conforming to criteria for a DSM-defined mood disorder.

Keywords: frontal lobe; frontotemporal dementia; genetics; neuropsychiatry; tau.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Comorbidity
  • Female
  • Frontotemporal Dementia / genetics*
  • Frontotemporal Dementia / psychology*
  • Genetic Predisposition to Disease
  • Heterozygote*
  • Humans
  • Male
  • Mental Disorders / genetics*
  • Mental Disorders / psychology*
  • Middle Aged
  • Mutation
  • New York City
  • Prevalence
  • Prodromal Symptoms
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • tau Proteins / genetics*


  • MAPT protein, human
  • tau Proteins