Puzzling Case: Is the Answer in the Genes?

Abstract

A 54-year-old male retired public servant was referred to the frontotemporal dementia clinic in 2008 with a history of insidious change in personality and behavior spanning over a decade. His wife first noticed a change in his personality in the late 1990s. He began to overspend on unnecessary items, and they lost their house when he failed to pay the mortgage. Over the ensuing few years, he was imprisoned on three occasions for fraudulent behavior. He was disinhibited in social situations, at times in a sexual manner. He held grandiose delusions about himself, for example, he often described himself as a champion bowler. On one occasion, he reported that he had been abducted in a helicopter and drugged which is why he had not appeared in court. In contrast to relatively preserved motivation, his ability to empathize and sympathize was profoundly reduced. He preferred to spend time alone. He could be mentally rigid, secretive, and at times aggressive.