J Psychiatr Res. 2013 Oct;47(10):1423-31. doi: 10.1016/j.jpsychires.2013.05.026. Epub 2013 Jun 19.
Characterization of depression in prodromal Huntington disease in the neurobiological predictors of HD (PREDICT-HD) study.
Epping EA1,
Mills JA,
Beglinger LJ,
Fiedorowicz JG,
Craufurd D,
Smith MM,
Groves M,
Bijanki KR,
Downing N,
Williams JK,
Long JD,
Paulsen JS;
PREDICT-HD Investigators and Coordinators of the Huntington Study Group.
Cross S, Ryan P, Epping EA, Vik S, Chiu E, Preston J, Goh A, Antonopoulos S, Loi S, Chua P, Komiti A, Raymond L, Decolongon J, Fan M, Coleman A, Ross CA, Varvaris M, Yoritomo N, Mallonee WM, Suter G, Macaraeg AS, Jones R, Wood-Siverio C, Factor SA, Barker RA, Mason S, Guzman NV, McCusker E, Griffith J, Loy C, Gunn D, Orth M, Süβmuth S, Barth K, Trautmann S, Schwenk D, Eschenbach C, Quaid K, Wesson M, Wojcieszek J, Guttman M, Sheinberg A, Law A, Perlman S, Clemente B, Geschwind MD, Sha S, Satris G, Warner T, Burrows M, Rosser A, Price K, Hunt S, Marshall F, Chesire A, Wodarski M, Hickey C, Panegyres P, Lee J, Tedesco M, Maxwell B, Perlmutter J, Barton S, Smith S, Miedzybrodzka Z, Rae D, D'Alessandro M, Craufurd D, Bek J, Howard E, Mazzoni P, Marder K, Wasserman P, Kumar R, Erickson D, Nickels B, Wheelock V, Kjer L, Martin A, Farias S, Martin W, King P, Wieler M, Sran S, Suchowersky O, Ahmed A, Rao S, Reece C, Bura A, Mourany L, Pallai J, Paulsen JS, Epping EA, Long JD, Johnson HJ, Bockholt JH, Montross K, Vonsattel JP, Moskowitz C, Harrington D, Hershey T, Westervelt H, Smith MM, Moser DJ, Williams J, Downing N, Johnson HJ, Aylward E, Ross CA, Magnotta VA, Rao S, Epping EA, Craufurd D, Long JD, Kim JI, Mills JA, Zhang Y, Liu D, Lu W, Lourens S, Erwin C, Epping EA, Williams J, Nance M, Bockholt JH, Wyse R.
- 1
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA 52242-1000, USA.
Abstract
Depression causes significant morbidity and mortality, and this also occurs in Huntington Disease (HD), an inherited neurodegenerative illness with motor, cognitive, and psychiatric symptoms. The presentation of depression in this population remains poorly understood, particularly in the prodromal period before development of significant motor symptoms. In this study, we assessed depressive symptoms in a sample of 803 individuals with the HD mutation in the prodromal stage and 223 mutation-negative participants at the time of entry in the Neurobiological Predictors of HD (PREDICT-HD) study. Clinical and biological HD variables potentially related to severity of depression were analyzed. A factor analysis was conducted to characterize the symptom domains of depression in a subset (n=168) with clinically significant depressive symptoms. Depressive symptoms were found to be more prevalent in HD mutation carriers but did not increase with proximity to HD diagnosis and were not associated with length of the HD mutation. Increased depressive symptoms were significantly associated with female gender, self-report of past history of depression, and a slight decrease in functioning, but not with time since genetic testing. The factor analysis identified symptom domains similar to prior studies in other populations. These results show that individuals with the HD mutation are at increased risk to develop depressive symptoms at any time during the HD prodrome. The clinical presentation appears to be similar to other populations. Severity and progression are not related to the HD mutation.
Copyright © 2013 Elsevier Ltd. All rights reserved.
KEYWORDS:
Depression; Genetic testing; Huntington disease; Suicide
Figure 1A
BDI-II Depression Severity (BDI-II > 13 indicating clinically significant symptoms) in HD CAG-Expansion Negatives and HD CAG-Expanded Individuals by CAG-Age Product (CAP) Group. Chi-square statistic for BDI > 13 between all expansion positive versus expansion negative = 30.7, p < 0.001.
J Psychiatr Res. ;47(10):10.1016/j.jpsychires.2013.05.026.
Figure 1B
BDI-II Severity (mild, moderate, or severe) in CAG-Expansion Negatives and CAG-Expanded Individuals by CAG-Age Product (CAP) Group. The percentages within each CAP group and the expansion negative group add up to the percent with BDI-II > 13 in (white bars).
J Psychiatr Res. ;47(10):10.1016/j.jpsychires.2013.05.026.
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