Prominent clinical perspectives posit that the interface of autism and (borderline) personality disorder manifests as either a misdiagnosis of the former as the latter or a comorbidity of both. In this editorial, we integrate these disparate viewpoints by arguing that personality difficulties are inherent to the autistic spectrum.

Frontotemporal dementia(FTD) is the prevalent type of primary progressive dementia. Psychiatric symptoms can be seen in FTD. So it can imitate psychiatric disorders and be misdiagnosed. However, few studies have investigated the underlying cause of misdiagnosis.

The primary aim of this study was to identify the prior psychiatric diagnoses of patients before receiving a definitive diagnosis of FTD and the main reasons to cause diagnostic delay.

We screened through the records of patients who were admitted to our psychiatry outpatient or inpatient clinic from January 1st, 2018 to June 30th, 2021. The patients with FTD were included in our study.

Our sample consisted of 13 patients with FTD(mean age= 54.77 ± 12.22, 7 females). Psychiatric misdiagnoses were depression(n=6), psychosis(n=5), bipolar affective disorder (n=5), conversion disorder(n=4), and malingering(n=1). As we looked at the first symptoms of the patients, it was revealed that 9 of 12 patients presented with depressive symptoms or at least experienced a short depressive period at the beginning of their behavioral changes. Interestingly, 8 of 12 patients had given a history of stressful life events just before their complaints emerged, which was thought the main misdirector for physicians. The average delays in diagnosis were 14.58(±16.93) months in the psychiatry clinic, 5.66(±11.02) months in the neurology clinic in our hospital.

Our study suggests that the depressive episode preceding behavioral changes may be the prodromal stage for fully developed FTD. Moreover, the depressive episode and the history of stressful life events appear to mislead clinicians in diagnosing FTD.

No significant relationships.

Ictal semiology interpretation for differentiating psychogenic nonepileptic seizures (PNESs) and epileptic seizures (ESs) is important for the institution of appropriate treatment. Our objective was to assess the ability of different health care professionals (HCPs) or students to distinguish PNES from ES based on video-recorded seizure semiology.

This study was designed following the Standards for Reporting of Diagnostic Accuracy Studies (STARD) guidelines. We showed in a random mix 36 videos of PNES or ES (18 each) and asked 558 participants to classify each seizure. The diagnostic accuracy of various groups of HCPs or students for PNES versus ES was assessed, as well as the effect of patient age and sex. Measures of diagnostic accuracy included sensitivity, specificity, and area under the curve (AUC).

The descending order of diagnostic accuracy (AUC) was the following (p ≤ 0.001): (1) neurologists and epileptologists; (2) neurology residents; (3) other specialists and nurses with experience in epilepsy; and (4) undergraduate medical students. Although there was a strong trend toward statistical difference, with AUC 95% confidence intervals (CIs) that were not overlapping, between epileptologists (95% CI 93, 97) compared to neurologists (95% CI 88, 91), and neurologists compared to electroencephalography technicians (95% CI 82, 87), multiple pairwise comparisons with the conservative Tukey–Kramer honest significant difference test revealed no statistical difference (p = 0.25 and 0.1, respectively). Patient age and sex did not have an effect on diagnostic accuracy in neurology specialists.

Visual recognition of PNES by HCPs or students varies overall proportionately with the level of expertise in the field of neurology/epilepsy.

To discuss the reasons for misdiagnosis of supernumerary nasal teeth.

Clinical data of four supernumerary nasal tooth patients were analysed retrospectively at visits to our otolaryngology department between 2005 and 2018.

All four patients were male and had a supernumerary nasal tooth in the right nasal cavity. Three of the four patients had previously been misdiagnosed. All the supernumerary nasal teeth were surrounded by granulation tissue or hypertrophic nasal mucosa, and were subsequently confirmed by computed tomography and endoscopy. The granulation tissue or hypertrophic nasal mucosa was removed using microwave ablation, and the supernumerary nasal teeth successfully removed by endoscopy.

Supernumerary nasal teeth are rare, and are usually misdiagnosed because such teeth are surrounded by hypertrophic nasal mucosa or granulation tissue. They can be confirmed by computed tomography and endoscopy.

The aim of this article is to draw attention to the clinical importance of disordered sleep in psychiatry and to demonstrate the growing awareness of medical illness as a complication of disordered sleep. As background to these main objectives, some general points are made to illustrate present-day approaches to the common and often serious problem of sleep disturbance.

The review is based on a literature search from which key publications were selected to illustrate, in turn, main connections between disordered sleep and psychiatric and medical conditions.

Many such connections are described. Throughout psychiatry, regarding patients whatever their age, these connections have implications for clinical assessment and management. Emphasis is placed on the risk of misdiagnosis of sleep disorders as psychiatric or medical conditions. Examples of this are provided. The growing evidence that disordered sleep can predispose to medical illness is discussed.

As the subject of sleep and its disorders is particular relevant in psychiatry, a working knowledge of modern sleep medicine is important in all branches of psychiatric and other medical practice as well as in clinical research.

We investigated the characteristics of Alzheimer's disease (AD) biomarkers for mild cognitive impairment (MCI) reversion to cognitively normal (CN).

Of a total of 1,233 participants from the ADNI database, 42 participants with MCI reversion to CN (MCIr), 778 with MCI, and 413 CN were obtained. We evaluated demographics, clinical outcomes, medication use, MCI type, and AD biomarkers, including genetic, cerebrospinal fluid, imaging, and neuropsychological data.

This study showed that the differences between MCIr and CN were only age, Mini-Mental State Examination, and Clinical Dementia Rating – Sum of Boxes, but the differences between MCIr and MCI were not only clinical outcomes but also AD biomarkers, including genetic, cerebrospinal fluid, imaging, and neuropsychological data. Overall, MCIr may be similar to CN and not MCI in clinical characteristics.

With assessment of MCI reversion to CN, the possibility of false-positive errors should be considered. With the assistance of AD biomarkers, MCI can be evaluated more accurately than the conventional criteria.

African-Caribbean and black African people living in the UK are reported to have a higher incidence of diagnosed psychosis compared with white British people. It has been argued that this may be a consequence of misdiagnosis. If this is true they might be less likely to show the patterns of structural brain abnormalities reported in white British patients. The aim of this study therefore was to investigate whether there are differences in the prevalence of structural brain abnormalities in white and black first-episode psychosis patients.

We obtained dual-echo (proton density/T2-weighted) images from a sample of 75 first-episode psychosis patients and 68 healthy controls. We used high resolution magnetic resonance imaging and voxel-based methods of image analysis. Two separate analyses were conducted: (1) 34 white British patients were compared with 33 white British controls; (2) 41 African-Caribbean and black African patients were compared with 35 African-Caribbean and black African controls.

White British patients and African-Caribbean/black African patients had ventricular enlargement and increased lenticular nucleus volume compared with their respective ethnic controls. The African-Caribbean/black African patients also showed reduced global grey matter and increased lingual gyrus grey-matter volume. The white British patients had no regional or global grey-matter loss compared with their normal ethnic counterparts but showed increased grey matter in the left superior temporal lobe and right parahippocampal gyrus.

We found no evidence in support of our hypothesis. Indeed, the finding of reduced global grey-matter volume in the African-Caribbean/black African patients but not in the white British patients was contrary to our prediction.