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Brain Sci. 2017 Jun 16;7(6). pii: E67. doi: 10.3390/brainsci7060067.

Neuropsychiatric Burden in Huntington's Disease.

Author information

1
Department of Psychiatry, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy. riccardo.paoli@guest.unimi.it.
2
Department of Psychiatry, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy. andrea.botturi@istituto-besta.it.
3
Department of Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan 20133, Italy. andrea.botturi@istituto-besta.it.
4
Department of Neurology-Stroke Unit and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy. a.ciammola@auxologico.it.
5
Department of Neurology-Stroke Unit and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy. vincenzo@silani.com.
6
Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan 20122, Italy. vincenzo@silani.com.
7
Department of Psychiatry, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy. crprunas@gmail.com.
8
Department of Philosophy, Università degli Studi di Milano, Milan 20122, Italy. claudio.lucchiari@unimi.it.
9
Department of Psychiatry, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy. elisazugno@gmail.com.
10
Department of Psychiatry, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy. calettielisabetta@gmail.com.

Abstract

Huntington's disease is a disorder that results in motor, cognitive, and psychiatric problems. The symptoms often take different forms and the presence of disturbances of the psychic sphere reduces patients' autonomy and quality of life, also impacting patients' social life. It is estimated that a prevalence between 33% and 76% of the main psychiatric syndromes may arise in different phases of the disease, often in atypical form, even 20 years before the onset of chorea and dementia. We present a narrative review of the literature describing the main psychopathological patterns that may be found in Huntington's disease, searching for a related article in the main database sources (Medline, ISI Web of Knowledge, Scopus, and Medscape). Psychiatric conditions were classified into two main categories: affective and nonaffective disorders/symptoms; and anxiety and neuropsychiatric features such as apathy and irritability. Though the literature is extensive, it is not always convergent, probably due to the high heterogeneity of methods used. We summarize main papers for pathology and sample size, in order to present a synoptic vision of the argument. Since the association between Huntington's disease and psychiatric symptoms was demonstrated, we argue that the prevalent and more invalidating psychiatric components should be recognized as early as possible during the disease course in order to best address psychopharmacological therapy, improve quality of life, and also reduce burden on caregivers.

KEYWORDS:

Huntington’s disease; affective and nonaffective disorders.; cognitive impairment; psychiatric symptoms

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