Abstract
Three patients were presented in order to make differential diagnosis between affective disorder and dementia. All patients have diagnosis of affective disorder and they were in stable remission under antidepressive therapy. When pathological stealing occurred, there was a diagnostic dilemma: is it a new manifestation of affective disorder, rare side effect of serotonergic antidepressants or symptom of dementia. Neuroimaging methods, as well as neuropsychological testing identified that in these patients other symptoms of prefrontal dementia also existed. Frontotemporal dementia (FTD) is frequently misdiagnosed with depression, and so far, inadequately treated with higher doses of antidepressants. Such therapy could worsen clinical feature. These patients were successfully treated with combination of memantine and low doses of serotonergic antidepressants. In the future, multicentric investigation should be conducted to confirm effective therapeutic combination of psychopharmacs in cases of pathological stealing in FTD.
Highlights
Kleptomania implies an extra-strong need of stealing, preceded by an increase in tension by the act of theft itself and followed by feelings of excitement and satisfaction [1,2,3,4]
The first symptom of frontotemporal dementia can manifest in form of behavioural changes, like pathological stealing
When symptoms such as pathological stealing, loss of empathy, as well as problems with impulse control, affective turbulence, concentration etc. occur in patients in remission of depressive disorder, it is not clear if symptoms appear as a recidive of depressive disorder or as symptoms of another disorder, possibly dementia [13,14,15,16,17,18]
Summary
Kleptomania implies an extra-strong need of stealing, preceded by an increase in tension by the act of theft itself and followed by feelings of excitement and satisfaction [1,2,3,4]. Feelings of satisfaction and guilt occur together with the desire to return the stolen item Frequent repetition of this act does damage to the material, social and family environment. Kleptomania is classified as an impulse-control disorder in ICD-10 (International Classification of Diseases, 10th revision), under code F63.2 [5,6,7]. It can be manifested along with symptoms of obsessive-compulsive spectrum, mood disorders, schizophrenia, and personality disorders and as a result of disinhibition in dementia [8,9,10,11,12].
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