Secondary Schizophrenia (83 page)

dence that delusions, misidentifications, and halluci-At study entry, 34% of the patients experienced delu-nations in AD may have a different underlying pat-sions and 7% hallucinations. Seventy percent devel-tern of risk factors and clinical outcomes. Psychosis
oped delusions and 33% hallucinations at any time
in AD has been the topic of a meeting of the Fed-during follow-up. The authors interpreted this finding
eral Drug Administration in the United States as a
as an indication of fluctuation of symptoms, but also
possible future target for drug development
[102].

as an increase in the prevalence of psychotic symptoms
Larger nonpharmacological intervention studies tar-during the course of the illness.

geting specific psychotic symptoms are also needed
Delusions, and even more so hallucinations, were
[100].

associated with an increased risk of cognitive and func-A future scenario in which subtypes of AD would
tional decline. Hallucinations were associated with an
be identifiable with the help of genetic and neuro-increased risk of institutionalization (RR
=
1.94; 95%

biological markers, and specific psychotic symptoms
CI
=
140–2.70) and death (RR
=
1.52; 95% CI
=
1.08–
might be treatable with genetically engineered drugs,
2.15) during follow-up, whereas delusions were not.

is still outside our immediate reach. However, research
The authors highlight the new finding of increased
already has started on this path in trying to better iden-cognitive deterioration and mortality in AD patients
tify and describe phenotypes and corresponding geno-

209

with hallucinations compared to previous studies.

types of subtypes of AD.

Organic Syndromes of Schizophrenia – Section 3

References

12. Burns A., Jacoby R., Levy R.

22. Edwards-Lee T., Miller B. L.,

Psychiatric phenomena in

Benson D. F.,
et al.
The temporal

1. Kraepelin E. 1899. Psychiatrie.

Alzheimer’s disease, II: disorders

variant of frontotemporal

Ein Lehrbuch für Studirende und

¨

of perception. Br J Psychiatry,

dementia. Brain, 1997.

Arzte. 6th Ed., Vol. II. Nijmegen:

1990.
157
:78–81, 92–4.

120
:1027–40.

Reprint, Arts & Boeve.

13. Jeste D. V., Finkel S. I. Psychosis of
23. Wilhelmsen K. C., Lynch T.,

2. Kraepelin E. 1910. Psychiatrie.

Alzheimer’s disease and related

Pavlou E.,
et al.
Localization of
Ein Lehrbuch für Studierende und
¨

dementias. Am J Geriatr

disinhibition-dementia-

Arzte. 8th Ed., Vol. II. Leipzig:
Psychiatry, 2000.
8
(1):29–34.

Parkinsonism-amyotrophy

Johann Ambrosius Barth.

14. Sweet R. A., Nimogaonkar V. L.,
complex to 17q21–22. Am J Hum

3. Pick A. Senile Hirnatrophie als
Devlin B.,
et al.
Psychotic
Genet, 1994.
55
:1159–65.

Grundlage von

symptoms in Alzheimer disease:

24. Foster N. L., Wilhelemsen K.,
Herderscheinungen. Wiener klin

evidence for a distinct phenotype.

Sima A. A.,
et al.
Frontotemporal
Wschr, 1901.
14
:1–2.

Mol Psychiatry, 2003;
8
:383–
dementia and parkinsonism

4. Pick A. Zur Symptomatologie

92.

linked to chromosome 17: a

der linksseitigen

15. Cummings J. L. Organic

consensus conference. Ann

Schläfenlappenatrophie. Mschr

delusions: phenomenology,

Neurol, 1997.
41
(6):706–15.

Psychiat Neurol, 1904.
16
:
anatomical correlations, and

25. Houlden H., Baker M., Adamson
378–88.

review. Br J Psychiatry, 1985;

J.,
et al.
Frequency of tau
5. Pick A. ¨

Uber einen weiteren

146
:184–97.

mutations in three series of

Symptomenkomplex im Rahmen

16. Ballard C., Holmes C., McKeith I.,
Non-Alzheimer’s degenerative

der Dementia senilis, bedingt

et al.
Psychiatric morbidity in
dementia. Ann Neurol, 1999.

durch umschriebene stärkere

dementia with -Lewy bodies: a

46
:243–8.

Hirnatrophie (gemischte

prospective clinical and

26. Poorkaj P., Grossman M.,

Apraxie). Monatsschr Psychiatr,

neuropathological comparison

Steinbart E.,
et al.
Frequency of
1906.
19
:97–108.

study with Alzheimer’s disease.

tau gene mutations in familial and
6. Stertz G. ¨

Uber die Picksche

Am J Psychiatry, 1999.

sporadic cases of non-Alzheimer

Atrophie. Z Gesainte Neurol

156
:1039–45.

dementia. Arch Neurol, 2001.

Psychiatr, 1926.
101
:
17. Lyketsos C. G., Breitner J. C. S.,
8
(3):383–7.

729–47.

Rabins P. An evidence-based

27. Rosso S. M., Kaar L. D., Baks T., et
7. Alzheimer A. ¨

Uber eine

proposal for the classification of
al. Frontotemporal dementia in

eigenartige Erkrankung der

neuropsychiatric disturbance in

The Netherlands: patient

Hirnrinde. Allg Z Psychiatr, 1907.

Alzheimer’s disease. Int J Geriatr
characteristics and prevalence

64
:146–8.

Psychiatry, 2001.
16
:1037–42.

estimates from a

8. Spielmeyer W. (1912). Die

18. Cook S. E., Miyahara S., Bacanu
population-based study. Brain,

Psychosen des Rückbildungs-und

S-A.,
et al.
Psychotic symptoms
2003.
126
:2016–22.

Greisenalters. In Handbuch der

in Alzheimer disease. Am J

28. van Swieten J., Spillantini M. G.

Psychiatrie, Aschaffenburg, G.

Geriatr Psychiatry, 2003.
11
:
Hereditary frontotemporal

(Ed.). Leipzig, Wien: Deuticke.

406–13.

dementia caused by tau gene

9. Runge W. (1930). Psychotisch

19. Perez-Madrinan G., Cook S. E.,
mutations. Brain Pathol, 2007.

ausgebaute Sonderformen der

Saxton J. A.,
et al.
Alzheimer
17
:63–73.

senilen Demenz. In Handbuch der

disease with psychosis. Excess

29. Forman M. S.

Geisteskrankheiten, vol 8.

cognitive impairment is restricted
Genotype-phenotype correlations

Bumke, O. (Ed.). Berlin: Julius

to the misidentification subtype.

in FTDP-17: does form follow

Springer.

Am J Geriatr Psychiatry, 2004.

function? Exp Neurol, 2004.

10. Jacob G. Analyse eines Falles von
12
:449–56.

187
:229–34.

seniler Demenz. (Störungen der

20. Cummings J. L. Toward a

30. Ingram E. M., Spillantini M. G.

Orientierung, des Denkens, der

molecular neuropsychiatry of

Tau gene mutations: dissecting the
Realitätserfassung.) Z ges Neurol.,
neurodegenerative diseases. Ann

pathogenesis of FRTD-17. Trends

1928;
116
:25–43.

Neurol, 2003.
54
:147–54.

Mol Med, 2002.
8
(12):555–62.

11. Lauter H. Zur Klinik und

21. Gustafson L., Brun A., Passant U.

31. Bird T. D., Wijsman E. M.,

Psychopathologie der

Frontal lobe degeneration of

Nochlin D.,
et al.
Chromosome 17

Alzheimerschen Krankheit.

non-Alzheimer type. Baillieres

and hereditary dementia: linkage
210

Psychiat Clin, 1968.
1
:85–108.

Clin Neurol, 1992.
1
:559–82.

studies in three non-Alzheimer

Chapter 15 – Neurodegenerative disorders

families and kindreds with

Neuropsychol Soc, 2000.

positron emission tomography

late-onset FAD. Neurology, 1997.

6
(7):815–20.

study. J Neuropsychiatry Clin

48
:949–54.

41. Jeste D. V., Wragg R. E., Salmon
Neurosci, 2001.
13
(1):50–5.

32. Sumi S. M., Bird T. D., Nochlin D.,
D. P.,
et al.
Cognitive deficits of
50. Assal F., Alacon M., Solomon E.

et al.
Familial presenile dementia
patients with Alzheimer’s

C.,
et al.
Association of the
with psychosis associated with

disease with and without

serotonin transporter and

cortical neurofibrillary tangles
delusions. Am J Psychiatry, 1992.

receptor gene polymorphisms in

and degeneration of the amygdala.

149
(2):148–9.

neuropsychiatric symptoms in

Neurology, 1992.
42
(1):120–7.

42. Bassiony M. M., Steinberg M. S.,
Alzheimer disease. Arch Neurol,

33. Reed L. A., Grabowski T. J.,
Warren A.,
et al.
Delusions and
2004.
61
(8):1249–53.

Schmidt M. L.,
et al.
Autosomal
hallucinations in Alzheimer’s

51. Faber N. B., Rubin E. H.,

dominant dementia with

disease: prevalence and clinical
Newcomer J. W.,
et al.
Increased
widespread neurofibrillary

correlates. Int J Geriatr Psychiatry,
neocortical neurofibrillary tangle
tangles. Ann Neurol, 1997.

2000.
15
:99–107.

density in subjects with Alzheimer
42
:564–72.

43. Bassiony M. M., Warren A.,

disease and psychosis. Arch Gen

34. Mega M. S., Lee L., Dinov I. D., et
Rosenblatt A.,
et al.
Isolated
Psychiatry, 2000.
57
:1165–73.

al. Cerebral correlates of psychotic
hallucinosis in Alzheimer’s

52. Nacmias B., Tedde A., Forleo P., et
symptoms in Alzheimer’s’ disease.

disease is associated with

al. Association between 5-HT2A

J Neurol Neurosurg Psychiatry,

African-American race. Int J

receptor polymorphism and

2000.
69
:167–71.

Geriatr Psychiatry, 2002b.

psychotic symptoms in Alzheimer

35. Ropacki S. A., Jeste D. V.

17
:205–10.

disease. Biol Psychiatry, 2001.

Epidemiology of and risk factors
44. Förstl H., Burns A., Levy R.,
et al.

50
:472–5.

for psychosis of Alzheimer’s

Neuropathological correlates of

53. Holmes C., Smith H., Ganderton
disease: a review of 55 studies

psychotic phenomena in

R.,
et al.
Psychosis and aggression
published from 1990 to 2003. Am

confirmed Alzheimer’s Disease.

in Alzheimer’s disease: the effect
J Psychiatry, 2001.
162
:
Br J Psychiatry, 1994.
165
:53–9.

of dopamine receptor gene

2022–30.

45. Lai M. K. P., Lai O-F., Keene J., et
variation. J Neurol Neurosurg

36. Mendez M. F., Martin R. J., Smyth
al. Psychosis of Alzheimer’s

Psychiatry, 2001.
71
:777–9.

K. A.,
et al.
Psychiatric symptoms
disease is associated with elevated
54. Sweet R. A., Nimgaonkar V. L.,
associated with Alzheimer’s

muscarinergic M2 binding in the

Devlin B.,
et al.
Increased familial
disease. J Neuropsychiatry Clin

cortex. Neurology, 2001.
57
:805–
risk of the psychotic phenotype of
Neurosci, 1990.
2
:28–33.

11.

Alzheimer disease. Neurology,

37. Förstl H., Almeida O. P., Owen A.

46. Geroldi C., Akkawi N. M.,

2002.
58
:907–11.

M.,
et al.
Psychiatric, neurological
Galluzzi S.,
et al.
Temporal lobe
55. Starkstein S. E., Vazquez S.,
and medical aspects of