Mild Frontotemporal Neurocognitive Disorder (FT- NCD)
D.7.1. Terminology in the DSM-5 has been updated with the division of neurocognitive disorders into delirium, mild neurocognitive disorder, and major neurocognitive disorder. Major and mild neurocognitive disorders exist on a spectrum of cognitive and functional impairment. Furthermore, DSM-5 recognizes specific etiologic subtypes of neurocognitive dysfunction, such as Alzheimer’s disease. In addition to Alzheimer's, these include frontotemporal degeneration, Huntington’s disease, Lewy body disease, traumatic brain injury (TBI), Parkinson’s disease, prion disease, and dementia/neurocognitive issues due to HIV infection. Some can typically affect younger as well as older people. Mild neurocognitive disorder is also called slight cognitive impairment, while major neurocognitive disorder is generally considered full-out dementia.
Students are to read the case study posted below (Mr. D.) and answer the following questions regarding the information presented in the case study. Provide rationale and evidence based citations to support responses.
The following components must be addressed in the discussion post:
What is the likely diagnosis? What assessment data supports your preliminary diagnosis?
Prevalence of the likely diagnosis?
Is it Permanent or Temporary?
What is the likely cause of disorder?
How is it diagnosed? Are there any labs or screening tools you would use to help in the diagnosis?
Are there any possible Differential Diagnoses and what are they?
What are the treatment options for this disorder?
Case Study: Mr. D
Mr. D. is a 55-year-old retired school teacher with no prior psychiatric history. He reports today to the clinic with his wife of 30 years. The wife indicates that he has undergone a shift in his personality and behavior. According to his wife, he has always been a very modest, humble, church going man. However he has engaged in several incidents of inappropriate sexual comments to complete strangers. They have quit going to church because this behavior has become so problematic. In fact upon beginning the interview with Mr. D. he told the PMHNP, "Hey, take off that lab coat so I can see what you got underneath. In fact, you can take it all off." When asking about the family history, the wife indicates that Mr. D is adopted and they do not know his family history. In addition, he had to retire early because of his change in personality. He was even propositioning the children he was teaching. The symptoms were particularly noticeable about a year ago when he began having problems expressing himself and understanding emails and other correspondence.
Brief Mental Status Exam
Appearance: Well-nourished, appropriately dressed
Motor: No psychomotor retardation or agitation
Speech: Tangential and circumstantial at times, disorganized, moderate rate/tone/volume, sparse content
Affect: Blunted
Mood: "I'm feeling good. Want to see how I feel?"
Thought process: Somewhat disorganized at times, circumstantial and tangential at times, easily digresses from the current subject to sexual themes
Thought content: Denies suicidal/homicidal ideations, denies self harm behaviors/thoughts, denies A/V hallucinations, no reaction to internal stimuli observed. No overt delusional comments made during exam. Rarely expanded when asked questions.
Abstraction: Impaired
Memory: Impaired
Concentration: Impaired
Social History:
First marriage with 2 children
Retired school teacher
Normal Weight, enjoys walking
Does not smoke or drink and has no history of same. No history of substance abuse.
Wife is supportive
Past Psychiatric History
Unremarkable
Past Medical History
Unremarkable
Current Medications
MVI once a day
Melatonin 10 mg at bedtime prn sleep
Discussion Assignment Module 7 Case Study
Student’s Name
Institutional Affiliation
Course Code and Title
Instructor’s Name
Due Date
Likely Diagnosis and Assessment Data
The likely diagnosis for this case is mild frontotemporal neurocognitive disorder (FT- NCD). According to APA (2013), one diagnostic criterion is that Mr. D has had cognitive decline, seen from the evident deterioration of his performance, impaired memory, abstraction, and concentration. Eventually, this has been expressed as a significant personality and behavior change. For instance, he is unable to understand emails and has been having problems expressing himself. Another criterion is that even though Mr. D has had cognitive decline, it does not interfere with his capacity to carry out his activities of daily living (APA, 2013). From his assessment data, he is well-nourished and appropriately dressed. Another criterion is that he has had a prominent decline in his language ability (APA, 2013). His assessment data shows that he randomly digresses into irrelevant details with sparse and disorganized content. His thought process is also disorganized and tangential in how he digresses into sexual themes and content. Therefore, mild frontotemporal neurocognitive disorder is the most likely diagnosis for Mr. D's case.
Prevalence
Mild Ft-NCD is increasingly becoming a cause for early onset neurocognitive disorder in people below sixty-five years. According to APA (2013), its prevalence ranges between two to ten people per eve...