title: The Confluence of Psychiatric Symptoms and Neurodegenerative Disease: Impact on Genetic Counseling.
abstract: Hereditary neurodegenerative diseases can present with a psychiatric prodrome that overlaps with psychiatric symptoms that are not primary to these diseases. When individuals present for predictive testing while experiencing such symptoms, clinicians including genetic counselors, must proceed with caution and evaluate each situation on a case-by-case basis. Legitimate reasons may exist for moving forward with testing. Additionally predicting the consequences of testing is unrealistic so that the clinicians must do their best to prepare patients for both positive and negative results. A multidisciplinary team following the Huntington disease protocol remains the gold standard care for predictive testing for such patients. We discuss 3 case histories that demonstrate the complex nature of genetic counseling and testing in the presence of psychiatric symptoms, whether emanating from the disease itself or the results of living in an affected family.
authors.affiliation: Taub Institute, Columbia University Medical Center, 630 W. 168th St., Box 16, New York, NY, 10032, USA. jg2673@cumc.columbia.edu.
authors.forename: Jill S
authors.initials: JS
authors.lastname: Goldman
authors.affiliation: Department of Neurology, Columbia University Medical Center, New York, NY, USA.|Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Huey
authors.affiliation: Department of Neurology, Columbia University Medical Center, New York, NY, USA.
authors.forename: Deborah Z
authors.initials: DZ
authors.lastname: Thorne
mesh_terms: D000328:Adult; D003376:Counseling; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D005817:Genetic Counseling / Q000523:psychology*; D005820:Genetic Testing; D006801:Humans; D006816:Huntington Disease / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D055815:Young Adult
keywords: Frontotemporal dementia; Huntington disease; Neurodegenerative disease; Predictive testing; Psychiatric symptoms