Evidenced-based Psychotherapy Assignment

Major Frontotemporal Neurocognitive Disorder

Introduction

Major frontotemporal neurocognitive disorder (MFND) is a neurologic disease where the temporal and frontal lobes of the cerebral cortex. The condition is mostly observed in individuals aged between 45-65 years. Major frontotemporal neurocognitive disorder is characterized by changes in social skills, personality, reasoning, motivation, language abnormality, and problems in concentration (Bott et al, 2014).

The diagnostic criteria of MFND includes: evidence of major decline in cognition in either language, social cognition, complex attention, learning and memory, executive function, and perceptual-motor as evidenced by the concern that the cognitive function has declined significantly and significant impairment in performing cognition as per neuropsychological testing or any other validated clinical assessment (Davidescu et al, 2015). The cognitive deficits should inhibit the ability of the person to perform activities of daily living and the deficits should not exist solely in a delirium context. Lastly, the cognitive defects should not be caused by any other psychiatric disorder (Davidescu et al, 2015).Evidenced-based Psychotherapy Assignment

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Psychotherapy and Psychopharmacologic Treatments

Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline and fluvoxamine are utilized as the first-line treatment choice when it comes to managing disinhibition, inappropriate behaviors, impulsivity, stereotypies, and irritability, in people with major frontotemporal neurocognitive disorder (Tsai & Boxer, 2016).

Atypical antipsychotics like olanzapine, clozapine, risperidone, and quetiapine have been used in individuals with MFND to control psychotic symptoms (Young et al, 2018). Methylphenidate is also used to reduce risk-taking behaviors and other behavioral problems because they target deficits in noradrenergic systems and dopaminergic systems in people with MFND (Tsai & Boxer, 2016).

Other forms of therapies include exercises in order to improve cognition, mood, and health of people with major frontotemporal neurocognitive disorder. In addition, balance training and physical therapy are performed by occupational therapists because this population has movement dysfunction and fine motor difficulties. Speech pathologists also perform speech therapy to treat neurodegenerative aphasias (Tsai & Boxer, 2016). Environmental approaches focusing on reducing aggression, anxiety, and irritability have also been demonstrated to be effective. The environmental interventions include noise reduction, reducing stimulation and streamlining social parameters and removing complex activities of daily living, have been shown to reduce agitation, and disinhibition (Young et al, 2018).

Risks of Different Types of Therapies

Atypical antipsychotics are allied to an increased risk of mortality and other extrapyramidal side effects.  Therefore, due to risks associated with atypical antipsychotics, nonpharmacological interventions are the preferred treatment options for people with major frontotemporal neurocognitive disorder (Young et al, 2018). In addition, even though SSRIs are not FDA approved to treat major frontotemporal neurocognitive disorder, most SSRIs such as citalopram have been shown to improve behavioral symptoms that include apathy, irritability, aggression, depression, and disinhibition (Tsai & Boxer, 2016). Evidenced-based Psychotherapy Assignment

References

Bott N, Radke A, Stephens M & Kramer J. (2014). Frontotemporal dementia: diagnosis, deficits and management. Neurodegener Dis Manag. 4(6): 439–454.

Davidescu D, Tudose C & Popa C. (2015). Frontotemporal Neurocognitive Disorder: a Challenging Diagnosis. European Psychiatry. 30(1), 28-31.

Tsai R & Boxer A. (2016). Therapy and clinical trials in frontotemporal dementia: past, present, and future. J Neurochem. 138(Suppl 1), 211–221.

Young J, Mallika L, Deena T & Rajesh T. (2018). Frontotemporal dementia: latest evidence and clinical implications. Ther Adv Psychopharmacol. 8(1), 33–48.

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Evidenced-based Psychotherapy Assignment