F42 Prevalence of psychiatric morbidity in the huntington’s disease community

Background

Psychiatric morbidity is part of HD and patients experience a range of disorders and symptoms. Family members, both those at risk and not at risk, also experience psychiatric distress. The treatment of psychiatric disturbances is an essential part of HD care.

Aim

The overall prevalence of psychiatric morbidity in the HD community was assessed to inform clinicians about the need for support and treatment.

Methods

Data were analyzed from 140 participants of the Medstar Georgetown University Hospital Enroll-HD registry. Participants were categorized as family controls, genotype unknown, premanifest HD, and manifest HD. The overall prevalence of psychiatric morbidity was the summation of the presence of moderate symptoms on Problem Behaviours Assessment – Short (PBA–S), defined as a score of 4 or greater (severity × frequency), plus comorbid psychiatric history.

Results

Demographic data showed gender and years of education were distributed equally between groups. Family controls were the oldest in age, whereas employment rate was lowest in manifest HD. PBA-S revealed the presence of psychiatric symptoms in family control 48%, genotype unknown 74%, premanifest HD 42% and manifest HD 80%. For participants that did not meet criteria of moderate symptoms on PBA-S, there was a history of comorbid psychiatric diagnoses in the family control 19%, genotype unknown 21%, premanifest HD 25% and manifest HD 16%. The most common comorbid psychiatric diagnoses were depressive disorders and anxiety disorders. The total prevalence of active psychiatric symptoms and comorbid psychiatric history was 66% for the family controls, 95% for genotype unknown, 67% for premanifest HD, and 96% for manifest HD; these were statistically significant (p <0.05). Many of the participants were receiving psychotherapeutic interventions consisting of psychopharmacology and psychotherapy.

Conclusions

HD families experience psychiatric symptoms and diagnosed psychiatric disorders. Though psychiatric morbidity is recognized, diagnosed, and treated in many HD families, the high prevalence of mental health disturbances speaks to the need for support and treatment.