Psychiatric and behavioural manifestations of Huntington's disease

Abstract

SummaryPatients with Huntington's disease can be a challenge to psychiatrists and to psychiatric services. We present a patient whose case history illustrates this and underlines the need for prompt and adequate treatment of psychiatric problems in this population. We discuss the psychiatric and behavioural manifestations of the illness, the treatments available and the role of psychiatric services in providing care for people with Huntington's disease.

A qualitative study exploring the experiences of mindfulness training in people with acquired brain injury

“…Patients with frontal-temporal dementia can suffer from pervasive changes in personality and social behaviour, including disinhibition (Cummings & Pillai, 2016). Similar to individuals with dementia and PD, patients diagnosed with Huntington's disease also suffer from apathy, depression, anxiety, symptoms of psychosis and behavioural difficulties (Jauhar & Ritchie, 2010). Depression is diagnosed in 40% of individuals with Huntington's disease and they are over four times more likely to commit suicide than those of the general population (Baquero & Martín, 2015;Di Maio et al, 1993).…”

Psychosis, Treatment Emergent Extrapyramidal Events, and Subsequent Onset of Huntington’s Disease: A Case Report and Review of the Literature

“…Patients with an early age of onset and family history of HD seem to have a greater risk of developing psychosis. 1 , 10) Of the schizophrenia-like psychoses that occur in HD disease, the paranoid form is the most common subtype. 11) Though our patient has a strong family history of HD, she probably developed HD at the usual age of onset of HD around the fourth to fifth decade of life and with the potential for inexorable HD progression over the next 1–2 decades.…”

“…In addition to psychosis, there are other psychiatric co-morbidities such as personality changes, neurocognitive changes, depression, which can occur in up to 95% of patients with HD. 10) Most commonly, personality changes may occur including increasing suspiciousness, irritability, emotional lability, impulsivity, aggression or apathy, 1 , 9 , 11) which may suggest frontal lobe involvement. 14) Depression happens in up to 32–44% of HD patients, and can precede the more typical HD features, such as chorea and dementia by 2–20 years, and is thought to be related to early degeneration of the medial caudate.…”

“… 1 , 14) Subsequent to diagnosis of HD, patients may develop psychiatric manifestations such as aggression, impulsivity, affective changes such as depression, suicidality, or behavioural features including social withdrawal. 10) …”

Trinucleotide repeat disorders: An interesting interface between psychiatry and medicine

“…Huntington's disease is usually diagnosed by neurologists following assessment of chorea. However, the symptoms are heterogeneous, and undiagnosed patients may initially present to mental health services with psychiatric, behavioural or cognitive symptoms such as depression, aggression, psychosis or dementia (Jauhar 2010).…”