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Psych CASC / OSCEOld age psychiatry — neurocognitive disorders

Psych CASC / OSCE · Old age psychiatry — neurocognitive disorders

Explain frontotemporal dementia diagnosis and plan to patient and partner — CASC communication station

MRCPsych/FRANZCP-style communication station: explain bvFTD, contrast with psychiatric labels, outline care and medication limits, discuss genetic implications sensitively, and safety-net risk.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 57-year-old man with probable bvFTD and his wife want a plain-language explanation of the diagnosis, why this is not simply 'bad behaviour' or bipolar disorder, what tests including genetics mean, what treatments can and cannot do, and how to manage safety at home.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the memory/behaviour clinic. [2][3]

Candidate instructions. Explain probable behavioural variant frontotemporal dementia in plain language; address the wife's fear that he is "just selfish" or "manic"; outline why memory scores can look relatively good early; discuss supports and medication limits (including that Alzheimer tablets are not usually the right first step); mention genetics only with sensitivity and offer counselling rather than dumping risk statistics; cover driving/finances safety; check understanding. [1][2][3]

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References6ShowHide
  1. [1]Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia Brain, 2011.PMID 21810890
  2. [2]Bang J, Spina S, Miller BL Frontotemporal dementia Lancet, 2015.PMID 26595641
  3. [3]Piguet O, Hornberger M, Mioshi E, Hodges JR Behavioural-variant frontotemporal dementia: diagnosis, clinical staging, and management Lancet Neurol, 2011.PMID 21147039
  4. [4]Huey ED, Putnam KT, Grafman J A systematic review of neurotransmitter deficits and treatments in frontotemporal dementia Neurology, 2006.PMID 16401839
  5. [5]DeJesus-Hernandez M, Mackenzie IR, Boeve BF, et al. Expanded GGGGCC hexanucleotide repeat in noncoding region of C9ORF72 causes chromosome 9p-linked FTD and ALS Neuron, 2011.PMID 21944778
  6. [6]Schneider LS, Dagerman KS, Insel P Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials JAMA, 2005.PMID 16234500
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