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Obsessive-Compulsive Symptoms are Less Common in Huntington's Disease than Reported Earlier
Rainer Hoffmann1,2, Natalie Schröder2, Martin Brüne3
1Department of Neurology, Huntington Centre NRW, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Germany.
Background:
Previous research using the Symptom-Checklist-90-Revised (SCL-90-R) has shown that compulsive symptoms in Huntington's disease (HD) occur in 10% to 52% of all cases. The "Hamburger-Zwangsinventar" (HZI), a self-rating questionnaire comprising 188 items, taps into the domain of compulsiveness in greater detail, but has not been used in HD so far. In addition, little is known about the association of obsessive-compulsive symptoms with pre-clinical stages of HD.
Objective:
Comparison of OC symptoms measured by the SCL-90-R and the HZI in pre-HD and HD.
Methods:
29 premanifest mutation carriers (pre-HD) and 40 manifest HD patients completed both questionnaires. Clinical characteristics of HD were rated by using the UHDRS.
Results:
Compared to data from general population prevalence of OC symptoms were not higher as expected in preHD and only slightly elevated in manifest HD if using HZI. Both instruments detected more OC symptoms in HD patients compared to pre-HD. The SCL-90-R more often detects compulsivity than the HZI. Results of both questionnaires showed correlations to cognition, depression, and disease duration. Compared to findings from OCD patients, there was a subordinate role in the HZI subscale for "washing and cleaning" in HD.
Conclusions:
OC symptoms in pre-HD occur not more often than in general population. The HZI appears to be useful for examining OC symptoms in detail in pre-HD and HD. HZI-subscale ratings for washing and cleaning compulsions were less pronounced in HD compared to OCD patients, possibly due to loss of disgust. The SCL-90-R might overestimate OC symptoms in both groups.