Psychiatric disorders in preclinical Huntington's disease
Psychiatric disorders in preclinical Huntington's disease
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DOI：
10.1136/jnnp.2006.103309
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发表时间：
2007-09-01
影响因子：
11
通讯作者：
Craufurd, David
中科院分区：
文献类型：
--
作者：
Julien, Camille L.;Thompson, Jennifer C.;Craufurd, David
背景：精神症状是亨廷顿病（HD）的常见特征，通常先于运动和认知障碍的发作。然而，目前尚不清楚临床前阶段的精神变化是否是结构变化引起的，是对处于风险的反应还是仅仅是巧合。很少有研究调查精神疾病的时间进程在整个preclinical periods.Objectives：比较精神疾病的终生患病率和当前患病率在presymptosis基因携带者和非携带者，并检查精神疾病患病率在基因携带者的临床发病时间接近的关系。使用结构化临床访谈，复合国际诊断访谈，获得了204个风险个体（89个基因携带者和115个非携带者）的一生和当前精神病史。精神疾病的分类使用标准化的诊断标准和更微妙的症状为基础的方法。随访的基因携带者（n = 51），使时间接近临床onset.Results的作用分析：基因携带者和非载体没有不同的临床精神疾病或亚临床症状的终生频率。然而，基因携带者报告说，目前抑郁症状的发生率明显较高。此外，抑郁症的发病率增加的功能接近临床onset.Conclusions：情感障碍是HD前驱阶段的一个重要特征。研究结果表明，抑郁症不能被解释为自然的担心处于危险之中。有证据表明，临床前症状明显的窗口期为数年。
Background: Psychiatric symptoms are a common feature of Huntington's disease ( HD) and often precede the onset of motor and cognitive impairments. However, it remains unclear whether psychiatric changes in the preclinical period result from structural change, are a reaction to being at risk or simply a coincidental occurrence. Few studies have investigated the temporal course of psychiatric disorder across the preclinical period.Objectives: To compare lifetime and current prevalence of psychiatric disorder in presymptomatic gene carriers and non- carriers and to examine the relationship of psychiatric prevalence in gene carriers to temporal proximity of clinical onset.Methods: Lifetime and current psychiatric histories of 204 at risk individuals ( 89 gene carriers and 115 non-carriers) were obtained using a structured clinical interview, the Composite International Diagnostic Interview. Psychiatric disorders were classified using both standardised diagnostic criteria and a more subtle symptom based approach. Follow-up of gene carriers ( n = 51) enabled analysis of the role of temporal proximity to clinical onset.Results: Gene carriers and non- carriers did not differ in terms of the lifetime frequency of clinical psychiatric disorders or subclinical symptoms. However, gene carriers reported a significantly higher rate of current depressive symptoms. Moreover, the rate of depression increased as a function of proximity to clinical onset.Conclusions: Affective disorder is an important feature of the prodromal stages of HD. The findings indicate that depression cannot be accounted for by natural concerns of being at risk. There is evidence of a window of several years in which preclinical symptoms are apparent.