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Published on: November 21, 2013
Characterization of psychiatric admissions in Huntington disease: A retrospective review
Shuhei Shiino1, Sarah Moroz2, Jeffrey Stovall3
1Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
Insights
Psychiatric crises are frequent in Huntington disease (HD), often requiring hospitalization. This study highlights the need for better emergency psychiatric care and integrated management strategies for HD patients.
Area of Science:
- Neuroscience
- Psychiatry
- Genetics
Background:
- Neuropsychiatric symptoms are prevalent in Huntington disease (HD).
- Existing guidelines for inpatient psychiatric treatment in HD are lacking.
- Mental health emergencies are common in HD patients.
Purpose of the Study:
- To analyze psychiatric hospitalizations in Huntington disease (HD) patients.
- To understand the mental health needs of HD patients.
- To identify gaps in psychiatric care for HD.
Main Methods:
- Retrospective chart review of HD patients admitted to psychiatry from 2013-2020.
- Data extraction from electronic health records.
- Analysis of admission indications, treatments, and follow-up care.
Main Results:
- 11.1% of HD patients experienced at least one psychiatric hospitalization.
- Common admission reasons included suicidal ideation/attempt, psychosis, and aggression.
- Most patients returned to their prior care level, but readmissions were frequent.
Conclusions:
- Psychiatric crises in HD are frequent and severe.
- Expanded emergency psychiatric care access is needed for HD patients.
- Further research should focus on integrated, disease-specific management of psychiatric symptoms in HD.
Objective:
Neuropsychiatric symptoms are common clinical features of Huntington disease (HD) that can result in mental health emergencies. However, there are no established guidelines for inpatient psychiatric treatment in HD. In this study, the investigators reviewed psychiatric hospitalizations in a large medical center to better understand the mental health needs of patients with HD and identify potential gaps in care.
Methods:
Charts were reviewed to identify patients with HD at Vanderbilt University Medical Center who were admitted to psychiatry between 2013 and 2020. Clinical data and demographic information were obtained from the electrical health record along with the indication for each psychiatric admission, actions taken during the admission, and follow-up care.
Results:
Among this cohort, 32 of 287 patients (11.1 %) were admitted to inpatient psychiatry at least once. Age at first admission ranged from 17 to 74 years, with 84.4 % of patients in the motor-manifest stage. The most common reasons for admission were suicidal ideation or attempt (57.6 %), psychosis (39.4 %), and aggression (36.4 %). Most patients were able to return to their previous level of care, although readmissions were common.
Conclusions:
These results emphasize the frequency and severity of psychiatric crises in HD and support the need for expanded access to emergency psychiatry care across the disease course. Further research is warranted to develop an integrated, disease-specific approach to early recognition and management of psychiatric symptoms in HD.
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