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Neurodegenerative disorder masquerading as psychosis in a forensic psychiatry setting

Sommerlad, A; Lee, J; Warren, J; Price, G; (2014) Neurodegenerative disorder masquerading as psychosis in a forensic psychiatry setting. BMJ Case Reports , 2014 10.1136/bcr-2013-203458. Green open access

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Abstract

A man presenting in his 50s, following conviction for a non-violent crime, to forensic psychiatric services, and then to a neuropsychiatry service with an unusual presentation of psychosis: second person auditory hallucinations, grandiose delusions and somatic delusions. Detailed collateral and family history revealed a background of progressive cognitive deficit and a family history of motor neuron disease. MRI of the brain revealed asymmetrical parieto-occipital volume loss and genetic testing demonstrated a pathogenic expansion of the chromosome 9 open reading frame 72 (C9ORF72) gene consistent with familial frontotemporal dementia caused by a hexanucleotide repeat expansion at C9ORF72, a recently discovered cause of familial frontotemporal dementia/motor neuron disease. This form of frontotemporal dementia should be considered as an important potential differential diagnosis for patients presenting with psychotic symptoms in later life, in whom a detailed family history and thorough cognitive assessment is essential.

Type: Article
Title: Neurodegenerative disorder masquerading as psychosis in a forensic psychiatry setting
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bcr-2013-203458
Publisher version: http://dx.doi.org/10.1136/bcr-2013-203458
Language: English
Additional information: This article has been accepted for publication in BMJ Case Reports following peer review. The definitive copyedited, typeset version, Sommerlad, A; Lee, J; Warren, J; Price, G; (2014) Neurodegenerative disorder masquerading as psychosis in a forensic psychiatry setting. BMJ Case Reports, 2014, is available online at: http://dx.doi.org/10.1136/bcr-2013-203458.
Keywords: Crime, Delusions, Diagnosis, Differential, Forensic Psychiatry, Frontotemporal Dementia, Hallucinations, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Mutation, Proteins, Psychotic Disorders
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/1452010
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