Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy.
BMC Psychiatry. 2023 Mar 30;23(1):216. doi: 10.1186/s12888-023-04709-9.
Fronto-Temporal Dementia (FTD) is a neurodegenerative disorder featuring frontotemporal lobe atrophy which leads to profound changes in behavior and cognition in the affected subjects. Considering that the onset of this type of dementia is typically characterized by the development of affective symptoms, differential diagnosis between FTD and Bipolar Disorder (BD) is particularly difficult. An important overlapping feature between BD and FTD is the presence of catatonic symptoms: Catatonia is extremely frequent in FTD, and, on the other hand, BD is the psychiatric disease with the highest frequency of association with catatonic states. In this framework, it should be noted that also Autism Spectrum conditions have been reported to show high rates of comorbidity and overlapping features with BD. In addition, subjects with autistic traits were reported to show an increased vulnerability towards the development of mood and anxiety disorders, as well as increase the risk of mood episodes with mixed features, suicidal thoughts and catatonic symptoms.
We reported the case of a patient with a diagnosis of both BD and FTD who showed catatonic symptoms.
The aim of this case report is to evaluate the possible role of autistic traits in the illness trajectory of BD and FTD.
This case confirms the presence of a continuum between psychiatric and neurological conditions, which should be considered as expressions of a same neurobiological system and further investigated in light of an integrative model.
额颞叶痴呆（FTD）是一种神经退行性疾病，其特征是额颞叶萎缩，导致受影响个体的行为和认知发生深刻变化。鉴于这种类型的痴呆症的发病通常以情感症状的发展为特征，因此 FTD 和双相情感障碍（BD）之间的鉴别诊断特别困难。BD 和 FTD 之间的一个重要重叠特征是存在紧张症症状：紧张症在 FTD 中极为常见，而另一方面，BD 是与紧张状态关联频率最高的精神疾病。在这种情况下，应该注意到自闭症谱系障碍也被报道具有较高的共病率和与 BD 的重叠特征。此外，具有自闭症特征的个体被报道表现出对情绪和焦虑障碍发展的易感性增加，以及混合特征的情绪发作、自杀念头和紧张症症状的风险增加。
我们报告了一例同时诊断为 BD 和 FTD 的患者，其表现出紧张症症状。
本病例报告的目的是评估自闭症特征在 BD 和 FTD 疾病轨迹中的可能作用。
该病例证实了精神和神经疾病之间存在连续性，应将其视为同一神经生物学系统的表现，并根据综合模型进一步研究。
