title: Obsessive and compulsive symptoms in prediagnosed Huntington's disease.
abstract: OBJECTIVE
  Obsessive and compulsive symptoms (OCS) are more prevalent in patients with diagnosed Huntington's disease (HD) than in the general population. Although psychiatric symptoms have been reported in individuals with the HD gene expansion prior to clinical diagnosis (pre-HD), little is known about OCS in this phase of disease.
  
  
  METHODS
  The goal of this study was to assess OCS in 300 pre-HD individuals and 108 non-gene-expanded controls from the Neurobiological Predictors of Huntington's Disease (PREDICT-HD) study (enrolled between November 2002 and April 2007) using a multidimensional, self-report measure of OCS, the Schedule of Compulsions, Obsessions, and Pathologic Impulses (SCOPI). Additionally, pre-HD individuals were classified into 3 prognostic groups on the basis of age and CAG repeat length as "near-to-onset" (< 9 estimated years to onset), "mid-to-onset" (9-15 years to onset), and "far-to-onset" (> 15 years to onset). We compared the 3 pre-HD groups to the controls on SCOPI total score and 5 subscales (checking, cleanliness, compulsive rituals, hoarding, and pathologic impulses), controlling for age and gender.
  
  
  RESULTS
  All models showed a significant (p < .05) group effect except for hoarding, with an inverted-U pattern of increasing symptoms: controls < far-to-onset < mid-to-onset, with the near-to-onset group being similar to controls. Although the mid-to-onset group showed the most pathology, mean scores were below those of patients with diagnosed obsessive-compulsive disorder. SCOPI items that separated pre-HD individuals from controls were focused on perceived cognitive errors and obsessive worrying.
  
  
  CONCLUSIONS
  Subclinical OCS were present in pre-HD participants compared to controls. The OCS phenotype in pre-HD may present with obsessive worrying and checking related to cognitive errors and may be a useful target for clinical screening as it could contribute to functional status.
authors.affiliation: University of Iowa, Department of Psychiatry, MEB 1-321, Iowa City, IA 52242-1000, USA. leigh-beglinger@uiowa.edu
authors.forename: Leigh J
authors.initials: LJ
authors.lastname: Beglinger
authors.forename: Jane S
authors.initials: JS
authors.lastname: Paulsen
authors.forename: David B
authors.initials: DB
authors.lastname: Watson
authors.forename: Chiachi
authors.initials: C
authors.lastname: Wang
authors.forename: Kevin
authors.initials: K
authors.lastname: Duff
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Langbehn
authors.forename: David J
authors.initials: DJ
authors.lastname: Moser
authors.forename: Henry L
authors.initials: HL
authors.lastname: Paulson
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Aylward
authors.forename: Noelle E
authors.initials: NE
authors.lastname: Carlozzi
authors.forename: Sarah
authors.initials: S
authors.lastname: Queller
authors.forename: Julie C
authors.initials: JC
authors.lastname: Stout
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003192:Compulsive Behavior / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D009770:Obsessive Behavior / Q000453:epidemiology*; D015995:Prevalence; D016016:Proportional Hazards Models; D012306:Risk