Psychiatric symptoms in Huntington's disease before diagnosis: the predict-HD study.
BACKGROUND
Psychiatric disturbances are relatively common in manifest Huntington's disease (HD), but less is known about these symptoms in the earliest phase of the illness.


METHODS
This study examined self-reported psychiatric symptoms in a large sample (N = 681) of prediagnosed individuals who show the gene expansion for HD ("expansion-positive") compared with a sample of individuals who do not show the gene expansion but are at risk for HD ("expansion-negative").


RESULTS
Using baseline Symptom Checklist 90-Revised (SCL-90-R) data from the Predict-HD study, expansion-positive individuals reported significantly more psychiatric symptoms (e.g., depression, anxiety, obsessive-compulsiveness) than expansion-negative individuals. Within the expansion-positive group, individuals with more motor signs had higher levels of psychiatric symptoms. The SCL-90-R scores had stronger relationships with reported abilities to perform activities of daily living than other markers of HD. Finally, when companions of the expansion-positive individuals also completed the SCL-90-R on the participants, there was considerable consistency in the ratings of psychiatric symptoms.


CONCLUSIONS
Subtle, subclinical psychiatric symptoms are present in this prediagnosed HD sample, even though most are estimated to be more than 10 years from HD diagnosis. As suggested by other research, these subtle symptoms might be the earliest markers of the disease; however, longitudinal data are needed.
Duff
Kevin
K
Department of Psychiatry, University of Iowa, Iowa City, Iowa 52242-1000, USA. kevinduff@uiowa.edu
Paulsen
Jane S
JS
Beglinger
Leigh J
LJ
Langbehn
Douglas R
DR
Stout
Julie C
JC
D000328:Adult; D001526:Behavioral Symptoms / Q000503:physiopathology*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology*; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales