I NEED A RESPONSE FOR THIS ASSIGNMENT
My assigned neurocognitive disorder for this week’s discussion is major frontotemporal neurocognitive disorder. Per the DSM-5, diagnostic criteria for this disorder includes that criteria are met for both mild and major neurocognitive disorder and that there is an insidious onset and gradual progression (APA, 2013). Either (1) or (2) must be present: (1) the behavioral variant with three or more of the following behavioral symptoms: behavioral disinhibition, inertia or apathy, loss of empathy or sympathy, compulsive/ritualistic, preservative, or stereotyped behavior, or dietary changes and hyperorality (APA, 2013). There is also a prominent decline in executive abilities or social cognition (APA, 2013). (2) is the language variant which includes when the language ability shows a prominent decline including word finding, speech production, grammar, object naming, or word comprehension (APA, 2013). There is a relative sparing of memory, learning, and perceptual-motor function (APA, 2013). The disturbances are also not better explained by another neurodegenerative disease, cerebrovascular disease, the effects of a substance, or another disorder (APA, 2013). The difference in major and mild neurocognitive disorders are subtyped pathologically and etiologically on the basis of associated symptoms, time course, and if they interfere with independence in completing daily activities (APA, 2013).
Psychotherapeutic and Psychopharmacologic Treatment Risks and Benefits
According to Young et al. (2018), there are currently no FDA approved medications for the treatment of frontotemporal dementia. It is reported that there is a small number of studies that found selective serotonin reuptake inhibitors (SSRI) to be effective in managing behavioral symptoms and that stimulants may be helpful with apathy and disinhibition (Young et al., 2018). Antipsychotic medications have been used in this disorder to treat psychosis and agitation, but there is a great risk carried due to the safety and side effect profiles of these medications in this population (Young et al., 2018). However, if caring for extremely violent or disruptive patients with this disorder, these medication benefits may have to outweigh the risks (Tsai & Boxer, 2016). Tsai and Boxer (2016) discuss that cholinesterase inhibitors have been studied in the treatment of this disorder and were not found to be effective. When reviewing nonpharmacologic treatments for this disorder, physical therapy, occupational therapy, and speech therapy may be helpful treatment modalities for this disorder (Tsai & Boxer, 2016). Cognitive therapy and family therapies and interventions may be considered for these patients depending upon severity of their condition and what phase of the disease progression they are currently in (Rao et al., 2020).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Rao, G. P., Sivakumar, P. T., Srivastava, S., & Sidana, R. C. (2020). Cognitive Therapy and Family Intervention for Patients with Dementia and Psychosis. Indian journal of psychiatry, 62(Suppl 2), S183–S191. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_769_19
Tsai, R. M., & Boxer, A. L. (2014). Treatment of frontotemporal dementia. Current treatment options in neurology, 16(11), 319. https://doi.org/10.1007/s11940-014-0319-0
Young, J. J., Lavakumar, M., Tampi, D., Balachandran, S., & Tampi, R. R. (2018). Frontotemporal dementia: latest evidence and clinical implications. Therapeutic advances in psychopharmacology, 8(1), 33–48. https://doi.org/10.1177/2045125317739818