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Published on: November 21, 2013
Psychiatric Symptoms Among Adolescents and Young Adults With or Without the Huntingtin Gene Expansion
Kelly H Watson1, Abagail E Ciriegio1, Anna C Pfalzer1
1Departments of Neurology (Watson, Pfalzer, Snow, Diehl, McDonell, Claassen) and Pathology, Microbiology, and Immunology (Vnencak-Jones), Vanderbilt University Medical Center, Nashville; Department of Psychology and Human Development (Ciriegio, Snow, Compas), Vanderbilt University, Nashville; Department of Psychiatry, University of Iowa, Iowa City (Long).
Objective:
Using a multi-informant approach, the authors assessed the psychiatric symptoms of adolescents and young adults with or without the huntingtin gene expansion and examined the association of psychiatric symptoms with cumulative disease exposure, a measure taking into account age and genetic data.
Methods:
The sample included 110 participants with (N=71) or without (N=39) the gene expansion, along with 85 family members who provided collateral reports. Saliva samples were used for genetic testing. Participants reported psychiatric symptoms with the age- and informant-appropriate Achenbach System of Empirically Based Assessment measure.
Results:
Family member ratings indicated that young people (ages 10-39) with the gene expansion were more likely to exhibit depression symptoms, attention difficulties, and behavior problems compared with those without the gene expansion. Self-reports of these symptoms did not differ between the two groups and indicated elevated depression symptoms, attention difficulties, thought problems, and obsessive-compulsive symptoms in both groups. In family member reports, 25% and 15% of the individuals with the gene expansion exceeded the clinical cutoffs for internalizing and attention difficulties, respectively. Little support was found for an association between psychiatric symptoms and cumulative disease exposure.
Conclusions:
These findings suggest that young people from families affected by Huntington's disease are at elevated risk for psychiatric symptoms regardless of gene status or cumulative disease exposure. However, findings differed depending on the informant type. These results emphasize a need to screen for and monitor the psychiatric symptoms of all young people from families affected by Huntington's disease regardless of gene status.
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