Psychiatric symptoms in Huntington's disease the importance of reliable information – A case report

Abstract

Introduction

Huntington's Disease is an autosomal dominant neurodegenerative disease characterized by motor, psychiatric and cognitive symptoms. Irritability, affective disorders, apathy and psychosis are among the most frequent psychiatric symptoms and can predate the pre-clinical period.

Objective

The authors’ goal is to understand the complexity of Huntington's disease clinical presentation. Additionally, we present an illustrative clinical case.

Aims

To convey the importance of collecting reliable information in order to make a proper diagnosis.

Methods

A PubMed database review was performed using “Psychiatry”, “Psychiatric”, “Symptoms” and “Huntington's Disease” as keywords; retrieved papers were selected according to their relevance. The patient clinical record was reviewed.

Results

The authors report a case of a 39-year-old woman, who was referred in 2014, to a psychiatrist because of depressive mood and suicidal ideation with two suicidal attempts in the past 5 years. However, she did not disclose her family history of Huntington's disease neither to her GP nor her psychiatrist. She never complied with the treatment plan and was admitted, in November, into a psychiatric unit because of subtle motor changes and apathy, which had resulted in personal neglect. The diagnosis could only be made after a family interview was held and the family medical history was revealed.

Conclusions

Corroborative history from caregivers is of extreme importance in psychiatry. Early detection of symptoms can help mitigate the disease social impact. In our patient's case, by the time of proper diagnosis, she was estranged from her family and had endured distressing psychiatric symptoms without adequate treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.