Objective: This study was designed to investigate clinical predictors of depression in subjects with HD.

Background: Huntington’s disease (HD) is characterized by motor, cognitive and behavioral changes. Among several psychiatric symptoms, depression is of great relevance as it is considered a significant burden for both individuals with HD and their caregivers. In addition, the presence of depression is a predictor of suicidal ideation, attempts and completion. Despite the high frequency and significance of depressive symptoms in HD, there is a lack of predictive and prognostic data to guide clinicians in its management.

Methods: This study included 2,303 subjects with manifest HD from the Enroll-HD Database (December, 2015). A binary logistic regression (backward stepwise approach) was performed to ascertain the effects of general clinical characteristics, medical history of substance use and psychiatric/behavioral problems, motor and functional capacity and cognitive performance on the likelihood that subjects with HD present depression or suicidal ideation.

Results: In the final model (χ2 = 270.648, p < 0.0001), younger age at HD clinical diagnosis (OR=0.969, p=0.001), lower number of CAG repeats (OR=0.904, p=0.002), clinical history of irritability (OR=2.119, p<0.0001), violent/aggressive behavior (OR=1.492, p=0.040), apathy (OR=3.631, p<0.0001), psychosis (OR=3.658, p=0.001) and cognitive impairment (OR=1.409, p=0.024)], and female sex (OR=2.124, p<0.0001) remained as predictors on the likelihood of depression. Additional analyses revealed that depression was significantly associated with suicidal ideation (52.2% of subjects HD presenting history of depression had suicidal ideation, while only 7.5% of patients without history of depression had suicidal ideation, p<0.0001).

Conclusions: Depression is associated with a younger age at motor manifestations and a lower number of CAG repeats. Female sex, behavioral problems (noteworthy apathy and psychosis) and poorer cognitive performance were also predictors for depression in HD. This information can be used to guide clinicians when evaluating and treating depression in individuals with HD and more importantly, prompt clinicians to routinely screen patients for suicidal ideations in hopes of decreasing the frequency of suicidal attempts and completion in HD.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/investigating-the-clinical-predictors-of-depression-in-huntingtons-disease-an-enroll-hd-database-study/