Differences between Frontotemporal Dementia and Narcissistic Disorder
Frontotemporal dementia and narcissistic disorder are two different conditions. Frontotemporal dementia is a neurological disorder affecting the frontal and temporal lobes of the brain, whereas narcissistic disorder is a mental health disorder.
However, the behavioral variant of FTD and narcissistic disorder both affect the affected person's behavior, and the symptoms of such behavior vary.
What is Frontotemporal Dementia?
Frontotemporal dementia (FTD) is a term used to refer to neurodegenerative diseases of a type of dementia. It is characterized by progressive changes in behavior, executive function, or language.
These changes occur due to a progressive loss of neurons in the frontal and temporal cortices of the brain. The frontal and temporal lobes are involved in the control of behavior, personality, and language respectively [1].
It is quite a common type of dementia among patients younger than 65 years [2]. Due to its diverse presentations, FTD manifests in various forms, into behavioral, aphasic, and motor variants. Out of these, the behavioral variant is the most common type, involving personality changes, behavioral problems, and cognitive decline [1].
Genetics is an important risk factor for FTD. Although the disease is often sporadic, around 30% of all FTD cases are inherited with genetic mutations most commonly on genes Tau, Progranulin, and C9orf72. However, other genetic mutations are also present [3].
Unfortunately, this disease is often misdiagnosed as it may mimic other psychiatric disorders that also revolve around behavioral changes [4]. In addition, there is no effective treatment for FTD, although, with the progress in understanding the molecular basis for FTD, rational therapies are beginning to emerge [2].
What Is Narcissistic Disorder?
Narcissistic Disorder is a personality disorder in which the person needs deeply excessive attention and admiration and often has an inflated sense of self-importance.
It affects around 6.3% of the population and it is slightly more common in men than women [5].
People with narcissistic disorder often have a strong desire to be admired and have a strong sense of entitlement paired with an exaggerated sense of self-importance [6, 5].
However, often, such behavior is just a result of a fragile sense of self-worth and its overcompensation [6].
Narcissistic disorder leads to significant problems in many areas of one’s life. This includes work, school, and even relationships. Such problems may arise as the person feels the need for excessive admiration, and special treatment or may undergo interpersonal conflict and functional impairments [7].
There are three main aspects of narcissism [8]:
- Narcissism as a psychological construct in the sense of personality variable
- Narcissism as a personality accentuation as a factor of vulnerability for other psychological disorders
- Narcissism as a personality disorder in the sense of a psychiatric disease
What Are The Differences Between Frontotemporal Dementia And Narcissistic Disorder?
FTD and narcissistic disorder are two distinct conditions. However, we may see some overlapping symptoms, especially between the behavioral variant of FTD and narcissistic disorder.
Although we may see some behavioral abnormalities in both FTD and narcissistic disorder, the main difference is the nature of such behavior. While patients with FTD often present with apathy, disinhibition, or lack of motivation and understanding of social behavior, narcissistic disorder is characterized by a pervasive pattern of grandiosity, constant need for admiration, and a lack of empathy.
Further, FTD is associated with a progressive loss of brain cells, whereas patients with narcissistic disorder have not shown any signs of such neurodegeneration in the brain [9].
Patients with FTD also often present cognitive deficits which is not usually seen in people with narcissistic disorder. In FTD patients this is highlighted as problems with memory, language, and executive function [10, 11].
In conclusion, while FTD and narcissistic disorder can both result in significant behavioral changes, they are distinct conditions with different origins, symptoms, and progressions.
Can Frontotemporal Dementia And Narcissistic Disorder Occur Simultaneously?
Although FTD and narcissistic disorder are two distinct disorders, the question is whether they can overlap.
Frontotemporal dementia (FTD) and Narcissistic Personality Disorder (NPD) can coexist. Individuals with personality disorders, particularly those in the dramatic cluster like NPD, may have frontolimbic abnormalities that predispose them to develop neurodegenerative disorders like FTD 1. There is a case report of a patient with a history of NPD who later developed clinically diagnosed FTD, highlighting the challenge in differentiating between prodromal psychiatric features of FTD and primary psychiatric disorders 1. Additionally, there is a genetic correlation between FTD and psychiatric disorders like schizophrenia, suggesting shared genetic etiology and potential common molecular mechanisms contributing to overlapping clinical characteristics 2