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Depression and Huntington's Disease: Prevalence, Clinical Manifestations, Etiology, and Treatment

Published online by Cambridge University Press:  07 November 2014

James R. Slaughter ,
Matthew P. Martens  and
Kathleen A. Slaughter
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Abstract

In order to determine the extent to which depression complicates Huntington's disease (HD), we have analyzed the existing literature on depression in HD in order to report the prevalence, clinical manifestations, and treatment of HD depression. By means of MEDLINE literature searches and reviews of HD articles' bibliographies, we identified for our analysis 16 HD depression studies. Our results indicate that the prevalence of depression is 30% for all HD patients. Clinical manifestations of HD depression include a marked increased risk for suicide. The etiology of HD depression is unclear, but may be due to a number of factors, such as dysfunction in the caudate nucleus, dysfunction in the ventral striatum, and various genetic factors that are discussed in this review. Case reports and case series support the efficacy of standard antidepressant interventions in resolving symptoms of depression. Efficacious treatments reported in the literature include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and electro-convulsive therapy. In this study, the successful anecdotal treatment of seven consecutive HD depressed patients with sertraline suggests that sertraline may be a safe and efficacious treatment of HD depression.

Type
Feature Article
Information
CNS Spectrums , Volume 6 , Issue 4: Neuropsychiatric Comorbidities: A Meeting of Minds , April 2001 , pp. 306-308,325 - 326
Copyright
Copyright © Cambridge University Press 2001

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References

REFERENCES

1.Huntington, G. On chorea. Medical and Surgical Reporter. 1872;26:317.Google Scholar
2.Folstein, SE. Huntington's Disease: A Disorder of Families. Baltimore, MD: The Johns Hopkins University Press; 1989.Google Scholar
3.Cummings, JL. Behavioral and psychiatric symptoms associated with Huntington's disease. Adv Neurol. 1995;65:179–186.Google ScholarPubMed
4.Weigell-Weber, M, Schmid, W, Spiegel, R. Psychiatric symptoms and CAG expansion in Huntington's disease. Am J Med Genet. 1996;67:53–57.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
5.Gusella, JF, Altherr, MR, McClatchey, AI, et al.Sequence-tagged sites (STSs) spanning 4p16.3 and the Huntington's disease candidate region. Genomics. 1992;13:75–80.CrossRefGoogle Scholar
6.Dewhurst, K, Oliver, J, Trick, KLK, McKnight, AL. Neuro-psychiatric aspects of Huntington's disease. Confin Neurol. 1969;31:258–268.CrossRefGoogle ScholarPubMed
7.Mattson, B. Huntington's chorea in Sweden. Acta Psychiatr Scand. 1974;255:221–235.CrossRefGoogle Scholar
8.King, M. Alcohol abuse in Huntington's disease. Psychol Med. 1985;15:815–819.CrossRefGoogle ScholarPubMed
9.Oliver, JE. Huntington's chorea in Northamptonshire. Brit J Psychiatry. 1970;116:241–253.CrossRefGoogle ScholarPubMed
10.Pflanz, S, Besson, JAO, Ebmeier, KP, Simpson, S. The clinical manifestation of mental disorder in Huntington's disease: a retrospective case record study of disease progression. Acta Psychiatr Scand. 1991;83:53–60.CrossRefGoogle ScholarPubMed
11.Mendez, MF. Huntington's disease: update and review of neuropsychiatric aspects. Int J Psychiatry Med. 1994;24:189–208.CrossRefGoogle ScholarPubMed
12.Mindham, RHS, Steele, C, Folstein, MF, Lucas, J. A comparison of the frequency of major affective disorder in Huntington's disease and Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1985;48:1172–1174.CrossRefGoogle ScholarPubMed
13.Folstein, SE, Abbot, MH, Chase, GA, Jensen, BA, Folstein, MF. The association of affective disorder with Huntington's disease in a case series and in families. Psychol Med. 1983;13:537–542.CrossRefGoogle Scholar
14.Judd, LL, Kunovac, JL. Clinical characteristics and management of unipolar depressive disorders comorbid with neurological disorders. Neuropsychobiology. 1998;37:84–87.CrossRefGoogle ScholarPubMed
15.Scourfield, J, Soldan, JO, Gray, J, Houlihan, G, Harper, PS. Huntington's disease: Psychiatric practice in molecular genetic prediction and diagnosis. Brit J Psychiatry. 1997;170:146–149.CrossRefGoogle ScholarPubMed
16.Minski, L, Guttmann, E. Huntington's chorea: a study of thirty-four families. J Ment Sci. 1938;84:21–96.CrossRefGoogle Scholar
17.Rosenbaum, D. Psychosis with Huntington's chorea. Psychiatr Q. 1941;15:93–99.CrossRefGoogle Scholar
18.Heathfield, KWG. Huntington's chorea: Investigation into the prevalence of this disease in the area covered by the North East Metropolitan Regional Hospital Board. Brain. 1967;90:203–232.CrossRefGoogle ScholarPubMed
19.Bolt, JMW. Huntington's chorea in the west of Scotland. Brit J Psychiatry. 1970;116:259–270.CrossRefGoogle ScholarPubMed
20.Caine, ED, Shoulson, I. Psychiatric syndromes in Huntington's disease. Am J Psychiatry. 1983;140:728–733.Google ScholarPubMed
21.Folstein, SE, Chase, GA, Wahl, WE, McDonnell, AM, Folstein, MF. Huntington's disease in Maryland: Clinical aspects of racial variation. Am J Hum Genet. 1987;41:168–179.Google ScholarPubMed
22.Kurlan, R, Caine, E, Rubin, A, et al.Cerebrospinal fluid correlates to depression in Huntington's disease. Arch Neurol. 1988;45:881–883.CrossRefGoogle ScholarPubMed
23.Lipe, H, Schultz, A, Bird, TD. Risk factors for suicide in Huntington's disease: A retrospective case controlled study. Am J Med Genet. 1993; 48:231–233.CrossRefGoogle ScholarPubMed
24.Shiwach, R. Psychopathology in Huntington's disease patients. Acta Psychiatr Scand. 1994;90:241–246.CrossRefGoogle ScholarPubMed
25.Sorensen, SA, Fenger, K. Causes of death in patients with Huntington's disease and unaffected first degree relatives. J Med Genet. 1992;29:911–914.CrossRefGoogle ScholarPubMed
26.Di Maio, L, Squitieri, F, Napolitano, G, Campanella, G, Trofatter, JA, Conneally, PM. Suicide risk in Huntington's disease. J Med Genet. 1993;30:293–295.CrossRefGoogle ScholarPubMed
27.Farrer, LA. Suicide and attempted suicide in Huntington disease: Implications for preclinical testing of persons at risk. Am J Med Genet. 1986;24:305–311.CrossRefGoogle ScholarPubMed
28.Cummings, JL. Depression and Parkinson's disease: a review. Am J Psychiatry. 1992;149:443–454.Google ScholarPubMed
29.Stenager, EN, Wermuth, L, Stenager, E, et al.Suicide in patients with Parkinson's disease: An epidemiological study. Acta Psychiatr Scand. 1994;90:70–72.CrossRefGoogle ScholarPubMed
30.Lam, RW, Bloch, M, Jones, BD, et al.Psychiatric morbidity associated with early clinical diagnosis of Huntington disease in a predictive testing program. J Clin Psychiatry. 1988;49:444–447.Google Scholar
31.Schoenfeld, M, Myers, RH, Cupples, A, Berkman, B, Sax, DS, Clark, E. Increased rate of suicide among patients with Huntington's disease. J Neurol Neurosurg Psychiatry. 1984;47:1283–1287.CrossRefGoogle ScholarPubMed
32.Dewhurst, K, Oliver, JE, McKnight, AL. Sociopsychiatric consequences of Huntington's disease. Brit J Psychiatry. 1970;116:255–258.CrossRefGoogle ScholarPubMed
33.Krishnan, KRR, McDonald, WM, Escalona, PR, et al.Magnetic resonance imaging of the caudate nuclei in depression. Arch Gen Psychiatry. 1992;49:553–557.CrossRefGoogle ScholarPubMed
34.De Souza, EB. Corticotropin-releasing factor receptors: physiology, pharmacology, biochemistry and role in central nervous system and immune disorders. Psychoneuroendocrinology. 1995;8:789–819.CrossRefGoogle Scholar
35.Mayberg, HS, Starkstein, SE, Peyser, CE, Brandt, J, Dannals, RF, Folstein, SE. Paralimbic frontal lobe hypometabolism in depression associated with Huntington's disease. Neurology. 1992;42:1791–1797.CrossRefGoogle ScholarPubMed
36.Ford, MF. Treatment of depression in Huntington's disease with monoamine oxidase inhibitors. Brit J Psychiatry. 1986;149:654–656.CrossRefGoogle ScholarPubMed
37.Folstein, S, Folstein, M, McHugh, PR. Psychiatric syndromes in Huntington's disease. Adv Neurol. 1979;23:281–289.Google Scholar
38.Folstein, S, Folstein, M, HcHugh, PR. Diagnosis and treatment of Huntington's disease. Compr Ther. 1981;7:60–66.Google ScholarPubMed
39.Patel, SV, Tariot, PN, Asnis, J. L-deprenyl augmentation of fluoxetine in a patient with Huntington's disease. Ann Clin Psychiatry. 1996;8:23–26.CrossRefGoogle Scholar
40.Como, PG, Rubin, AJ, O'Brien, CF, et al.A controlled trial of fluoxetine in nondepressed patients with Huntington's disease. Mov Disord. 1997;12:397–401.CrossRefGoogle ScholarPubMed
41.Ranen, NG, Peyser, CE, Folstein, SE. ECT as a treatment for depression in Huntington's disease. J Neuropsychiatry Clin Neurosci. 1994;6:154–159.Google ScholarPubMed
42.Sajatovic, M, Verbanac, P, Ramirez, LF, Meltzer, HY. Clozapine treatment of psychiatric symptoms resistant to neuroleptic treatment in patients with Huntington's chorea. Neurology. 1991;41:156.CrossRefGoogle ScholarPubMed