Neurological diseases can mime all sorts of diseases or psychiatric illnesses. They often lead us to misperceive what they really are as soon as they start with psychiatric symptoms. When this is the case, patients could wrongly be oriented to psychiatry instead of being sent to other medical fields such as neurology. It’s even more relevant when these patients already suffered from psychiatric history.
Amongst neurological illnesses with a psychiatric mask, there are tumors and other less known diseases like fronto-temporal dementia (FTD), previously called Pick’s disease.
It’s a neurodegenerative disease occurring between 50 and 60 years old. It is similar to Alzheimer’s but less common. It is caused by a fronto-temporal atrophy. Almost all patients suffering from this disease are first sent to psychiatry because psychiatric symptoms are the first to appear. Usually patients experience insidious and progressive changes in personality and behavior modifications such as eating issues, apathy and stereotypes. Slowly, cognitive disorders will add up. All these symptoms will become more intense as the disease evolves. Relatives will start worrying about it, while the patient will not even be aware of all these changes. As a matter of fact, disorder’s particularity is the patient’s anosognosia. In other words, he’s not aware neither of his symptoms nor of the disease on its own.
More precisely, patients suffering form FTD noticed changes in their eating behavior which include more snacking or binge eating. Consequently, weight gain occurs. Emotional issues are also noted such as affective disregard with a loss of empathy or inappropriate behaviors according to the context (i.e. to laugh at a funeral). Apathy is also a symptom found in FDT. It’s characterized by a loss of interest and initiative in daily habits, clinophilia as well as social avoidance.
There are also two types of FDT found: the apathetic form or the uninhibited one. This is the reason patients can be diagnosed depressive, bipolar or in a manic state.
Regarding of the disease symptoms, we can easily be confused and think it’s a manic episode for example (euphoria, increased talking etc.). Nonetheless, when we look closer to the symptom characteristics, we figure that the patient is not in a manic state because he’s not being delusional, doesn’t have sleeping disorder or tachypsychia.
Bulimia is another psychiatric disorder often mistaken with FTD. However, if we conduct a differential diagnosis, we realise that binge eating in FTD is not followed by neither guilt nor intentional vomiting. People suffering from FTD don’t care about their weight in general whereas people suffering from bulimia do.
Psychotic symptoms (i.e. hallucinations, delirium) can also be at the forefront of some neurological illnesses. It could be impressive so it needs further investigation to establish the correct diagnosis.
Thus, if ever you want to see what these neurological diseases with a psychiatric mask look like, I suggest you watch “Brain on Fire” movie with Chloë Grace Moretz. Indeed, in this movie, a young girl with psychotic symptoms is sent to psychiatric hospital while she actually suffers from a rare neurological disease known as anti-NMDA receptor encephalitis.
This movie precisely illustrates how important it is to be well informed about these neurological illnesses with a psychiatric mask to avoid wrong diagnosis, serious consequences like tumors as well as to wrongly send a patient to psychiatry. Psychologists will potentially meet patient with this sort of symptoms. If professionals are not aware of these diseases, they might generate erroneous diagnostic hypotheses that could lead to wrong medical care.
WORDS WE HAVE LEARNED :
- Misperceive : Percevoir de manière erronée
- Relevant : Pertinent
- Fronto-temporal dementia : Démence fronto-temporale
- Insidious : Insidieux
- Anosognosia : Anosognosie
- Affective disregard : Indifférence affective
- Clinophilia : Clinophilie
- Social avoidance : Évitement social
- Uninhibited : Désinhibé
- Manic state : État maniaque
- Tachypsychia : Tachypsychie
- Differential diagnosis : Diagnostic différentiel
- Anti-NMDA receptor encephalitis : Encéphalite limbique à anticorps anti-récepteur NMDA
- Erroneous : Erroné
Charline Drapier – Gladys Rossoni – Lindsay Paingt