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New-Onset Delusions Heralding an Underlying Neurodegenerative Condition: A Case Report and Review of the Literature
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Overview
In this CME journal article, the authors describe a case of new-onset psychosis in a middle-aged woman, review red-flags for a neurodegenerative diagnosis rather than a primary psychotic disorder, and examine the role of genetics.
Read the whole article at psychiatrist.com here:
New-Onset Delusions Heralding an Underlying Neurodegenerative Condition: A Case Report and Review of the Literature
© Copyright 2020 Physicians Postgraduate Press, Inc.
Target Audience
Psychiatrists
Learning Objectives
Include neurodegenerative disease in the differential diagnosis for any patient presenting with new-onset psychosis and behavioral changes in mid-to-late adulthood
CME Background
Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.
CME Objective
After studying this article, you should be able to:
- Include neurodegenerative disease in the differential diagnosis for any patient presenting with new-onset psychosis and behavioral changes in mid-to-late adulthood
Statement of Need and Purpose
Diagnosing patients who have new-onset psychosis in middle age or older adulthood is challenging due to the overlap with neurodegenerative causes of psychosis. For example, symptoms of behavioral variant frontotemporal dementia (bvFTD) often mimic those of psychiatric disorders and commonly result in misdiagnoses. Failure to identify the cause of psychosis will delay appropriate management and possibly result in unnecessary exposure to antipsychotic drugs. An educational intervention for clinicians is needed to improve awareness of potential causes of dementia-related psychosis and to increase provision of appropriate testing.
Release, Expiration, and Review Dates
This educational activity was published in March 2020 and is eligible for AMA PRA Category 1 Credit™ through April 30, 2022. The latest review of this material was March 2020.
Disclosure of off-label usage
The authors have determined that, to the best of their knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.
Funding/support
No external funding sources were required for this work.
Acknowledgments
The authors thank the patient’s guardian for granting permission to publish this case and for being such a caring friend during the patient’s life.
Patient consent
The patient’s guardian provided consent to publish this case, and information has been de-identified to protect anonymity.
Faculty Affiliation
Emily A. Ferenczi, BM, BCh, PhD*
Department of Neurology, Brigham and Women’s Hospital, and Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
Michael G. Erkkinen, MD
Department of Neurology, Brigham and Women’s Hospital, and Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
Mel B. Feany, MD, PhD
Department of Pathology, Brigham and Women’s Hospital, Boston Massachusetts
Barry S. Fogel, MD
Department of Neurology, Brigham and Women’s Hospital, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, and Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
Kirk R. Daffner, MD
Department of Neurology, Brigham and Women’s Hospital, and Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
*Corresponding author: Emily A. Ferenczi, BM, BCh, PhD, Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 ([email protected]).
Financial Disclosure
All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Marlene P. Freeman, MD, Editor in Chief of The Journal of Clinical Psychiatry, has received research funding from JayMac and Sage; has been a member of the advisory boards for Otsuka, Alkermes, and Sunovion; has been a member of the Independent Data Safety and Monitoring Committee for Janssen; has been a member of the Steering Committee for Educational Activities for Medscape; and, as a Massachusetts General Hospital (MGH) employee, works with the MGH National Pregnancy Registry, which is sponsored by Teva, Alkermes, Otsuka, Actavis, and Sunovion, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. No member of the CME Institute staff reported any relevant personal financial relationships.
Drs Ferenczi, Erkkinen, Feany, Fogel, and Daffner have no personal affiliations or financial relationships with any commercial interest to disclose relative to the article.
Accreditation Statement
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Participation