FTD is a disease of the young subject that can appear between the ages of 50 and 60. Anatomically, it is characterised by frontotemporal atrophy, which affects the front of the brain. There is no treatment for this disease. FTD begins with behavioural problems, with a change in personality. There are also emotional and cognitive disorders. It is characterised by a lack of awareness of the disorders, called anosognosia. There are two main behavioural forms in this disorder: the apathetic form (loss of interest, motivation, pleasure) and the disinhibited form.
Behavioural and emotional symptoms include: physical and domestic neglect, altered eating behaviour, verbal and behavioural disinhibition, indiscriminate shopping, collecting disorders (accumulation of unusual objects), emotional and affective control disorders, apathy, and finally fixed ideas and stereotyped behaviour. Cognitive disorders include episodic memory disorders, executive function disorders (planning, inhibition, organisation, etc.), disturbances in the interpretation of emotional signals (facial expressions, prosody) and social skills (theory of mind: inability to interpret the emotions of others).
As future psychologists, we may be led to meet patients with this pathology, hence our interest in the movie called “Bonhomme” which, in our opinion, illustrates well this pathology and its consequences in the daily life. In this movie, a young couple living in the suburbs of Lille (Piotr and Marilyn) is upset by a car accident. Piotr suffers a serious head injury during the accident. The shock of the car accident causes a frontal syndrome that leaves him in a coma for several days. When he wakes up, he suffers from amnesia, but he has also lost all modesty and sociability. Memory disorders as well as anosognosia are represented in this movie. We can see that Piotr forgets all recent information, for example his appointments, turning off the gas. We also see that he is not aware of his disorder. Apathy and disinhibition (Piotr’s unbridled hypersexuality), behavioural symptoms mentioned earlier, are the predominant signs of Piotr’s FTD in the movie. Apathy in FTD as depicted in the film is characterised mainly by passive behaviour, loss of interest, no decision-making. As for verbal and behavioural disinhibition, the main signs are loss of tact in society, seeking unusual social contact, hurtful remarks to the loved ones, loss of social propriety, and sexual disinhibition. The movie highlights this sexual disinhibition in Piotr.
The movie also shows us the role of the carer in this pathology. Indeed, Piotr’s girlfriend, Marylin, tries as best she can to adapt to her companion’s new behaviour. She is convinced that her love for him can help him, and she does not want to give up. The movie is a good representation of the reality of the daily life of this carer, who is trying to keep her job in order to have enough income to take care of herself and especially her partner.
To conclude on this disease, it is known that there is no specific treatment. However, some treatments can be prescribed for behavioural disorders such as neuroleptics or anxiolytics. Multidisciplinary care is recommended for FTD patients. Speech therapy to help maintain language, psychological support for relatives as the patient’s anosognosia is a great suffering. There are also stimulation workshops in day care centres to reduce certain symptoms and relieve the carer. Finally, a psycho-education programme (presentation of the disease, explanations, advice) can be beneficial.
Words we have learned :
- Anosognosia = Anosognosie
- Fronto-temporal degeneration = dégénérescence fronto-temporale
- Carer = aidant
- disinhibition = désinhibition