Psych · Consultation-liaison psychiatry
Huntington disease psychiatry
Also known as Huntington's disease psychiatry · HD neuropsychiatry · Huntington disease depression · Huntington disease psychosis · Huntington irritability · Huntington suicide risk · Predictive testing Huntington psychiatry · VMAT2 Huntington psychiatry
Exam-exhaustive fellowship topic on the psychiatry of Huntington disease: premanifest and manifest neuropsychiatric syndromes, suicide risk, irritability and apathy, psychosis, expert-consensus psychopharmacology, VMAT2–mood interface, predictive testing ethics, and multidisciplinary CL–neurology care. FRANZCP-primary, globally tagged.
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10 MCQs with explanations
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Meet the patient
A 41-year-old teacher is brought in by her husband. She has not been diagnosed with anything. Her father died in a nursing home at 58 "with a movement disorder nobody explained". Over two years she has become short-tempered, has been stood down after an outburst at work, sleeps poorly, and last week said the family would be better off without her. Her fingers move slightly when she rests her hands.[1][5][8]
Every registrar reaches for the depression scale. The examiner is waiting to see whether you take the pedigree, ask the suicide question properly, and notice that the psychiatry arrived before the chorea.[6][8][9]
You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Psychiatry Fellowship fellowship atlas.
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- [1]van Duijn E, Craufurd D, Hubers AA, et al. Neuropsychiatric symptoms in a European Huntington's disease cohort (REGISTRY) J Neurol Neurosurg Psychiatry, 2014.PMID 24828898
- [2]Craufurd D, Thompson JC, Snowden JS Behavioral changes in Huntington Disease Neuropsychiatry Neuropsychol Behav Neurol, 2001.PMID 11725215
- [3]Rosenblatt A Neuropsychiatry of Huntington's disease Dialogues Clin Neurosci, 2007.PMID 17726917
- [4]Paoli RA, Botturi A, Ciammola A, et al. Neuropsychiatric Burden in Huntington's Disease Brain Sci, 2017.PMID 28621715
- [5]Hubers AA, van Duijn E, Roos RA, et al. Suicidal ideation in a European Huntington's disease population J Affect Disord, 2013.PMID 23876196
- [6]van Duijn E, Fernandes AR, Abreu D, et al. Incidence of completed suicide and suicide attempts in a global prospective study of Huntington's disease BMJ Ment Health, 2021.PMID 34462049
- [7]Wetzel HH, Gehl CR, Dellefave-Castillo L, et al. Suicidal ideation in Huntington disease: the role of comorbidity J Neuropsychiatry Clin Neurosci, 2011.PMID 21605914
- [8]Epping EA, Mills JA, Beglinger LJ, et al. Characterization of depression in prodromal Huntington disease in the neurobiological predictors of HD (PREDICT-HD) study J Neuropsychiatry Clin Neurosci, 2013.PMID 23790259
- [9]Epping EA, Kim JI, Craufurd D, et al. Longitudinal Psychiatric Symptoms in Prodromal Huntington's Disease: A Decade of Data Am J Psychiatry, 2016.PMID 26472629
- [10]Anderson KE, van Duijn E, Craufurd D, et al. Clinical Management of Neuropsychiatric Symptoms of Huntington Disease: Expert-Based Consensus Guidelines on Agitation, Anxiety, Apathy, Psychosis and Sleep Disorders J Huntingtons Dis, 2018.PMID 30040737
- [11]Groves M, van Duijn E, Anderson K, et al. An International Survey-based Algorithm for the Pharmacologic Treatment of Irritability in Huntington's Disease PLoS Curr, 2011.PMID 21975525
- [12]Huntington Study Group Tetrabenazine as antichorea therapy in Huntington disease: a randomized controlled trial Neurology, 2006.PMID 16476934
- [13]Frank S, Testa CM, Stamler D, et al. Effect of Deutetrabenazine on Chorea Among Patients With Huntington Disease: A Randomized Clinical Trial JAMA, 2016.PMID 27380342
- [14]Walker FO Huntington's disease Lancet, 2007.PMID 17240289
- [15]McColgan P, Tabrizi SJ Huntington's disease: a clinical review Eur J Neurol, 2018.PMID 28817209
- [16]van Duijn E Medical treatment of behavioral manifestations of Huntington disease Handb Clin Neurol, 2017.PMID 28947111