Longitudinal Psychiatric Symptoms in Prodromal Huntington’s Disease: A Decade of Data
Abstract
Objective:
Method:
Results:
Conclusions:
Method
Participants
Progression Groups
Measures
Statistical Analysis
Group comparison of baseline and longitudinal change.
Participant and companion comparison.
Results
Baseline and Longitudinal Change in Self-Reported and Companion-Reported SCL-90-R Ratings
Probability of Motor Diagnosis Within 5 Years | ||||||||
---|---|---|---|---|---|---|---|---|
Measure | Control Group (N=298) | Low Probability Group (N=280) | Medium Probability Group (N=356) | High Probability Group (N=371) | ||||
N | % | N | % | N | % | N | % | |
Female | 192 | 64.4 | 189 | 67.5 | 233 | 65.45 | 218 | 58.76 |
Mean | SD | Mean | SD | Mean | SD | Mean | SD | |
Ageb (years) | 44.11 | 11.76 | 34.16 | 8.47 | 40.45 | 9.6 | 44.42 | 10.34 |
Educationc (years) | 14.85 | 2.57 | 14.51 | 2.47 | 14.54 | 2.62 | 14.18 | 2.79 |
Median | Range | Median | Range | Median | Range | Median | Range | |
CAG lengthb | 19 | 12–35 | 41 | 36–47 | 42 | 38–49 | 43 | 39–61 |
Rating | Model | Group Effect | Participant AICc | Participant dAICc | Participant wAICc | Companion AIC | Companion dAICc | Companion wAICc |
---|---|---|---|---|---|---|---|---|
Global severity index | 1 | Null | 44820.28 | 31.77 | 0.00 | 40001.38 | 54.79 | 0.00 |
2 | Baseline | 44792.62 | 4.11 | 0.11 | 39968.83 | 22.24 | 0.00 | |
3 | Baseline + longitudinal | 44788.51 | 0.00 | 0.89 | 39946.59 | 0.00 | 1.00 | |
Positive symptom total | 1 | Null | 42831.61 | 33.29 | 0.00 | 38466.49 | 68.84 | 0.00 |
2 | Baseline | 42805.20 | 6.88 | 0.03 | 38430.43 | 32.78 | 0.00 | |
3 | Baseline + longitudinal | 42798.31 | 0.00 | 0.97 | 38397.65 | 0.00 | 1.00 | |
Positive symptom distress index | 1 | Null | 45463.96 | 23.74 | 0.00 | 40298.05 | 41.08 | 0.00 |
2 | Baseline | 45445.56 | 5.35 | 0.07 | 40263.78 | 6.82 | 0.03 | |
3 | Baseline + longitudinal | 45440.22 | 0.00 | 0.94 | 40256.97 | 0.00 | 1.00 | |
Somatization | 1 | Null | 42803.06 | 0.00 | 0.46 | 37634.13 | 10.62 | 0.01 |
2 | Baseline | 42803.70 | 0.64 | 0.34 | 37633.26 | 9.75 | 0.01 | |
3 | Baseline + longitudinal | 42804.76 | 1.70 | 0.20 | 37623.51 | 0.00 | 0.99 | |
Obsessive-compulsive symptoms | 1 | Null | 46037.23 | 66.08 | 0.00 | 40225.99 | 90.69 | 0.00 |
2 | Baseline | 45983.99 | 12.84 | 0.00 | 40165.93 | 30.63 | 0.00 | |
3 | Baseline + longitudinal | 45971.15 | 0.00 | 1.00 | 40135.30 | 0.00 | 1.00 | |
Interpersonal sensitivity | 1 | Null | 45460.40 | 21.75 | 0.00 | 40387.99 | 32.74 | 0.00 |
2 | Baseline | 45439.80 | 1.16 | 0.36 | 40364.90 | 9.65 | 0.01 | |
3 | Baseline + longitudinal | 45438.64 | 0.00 | 0.64 | 40355.25 | 0.00 | 0.99 | |
Depression | 1 | Null | 46069.77 | 30.01 | 0.00 | 40702.42 | 55.57 | 0.00 |
2 | Baseline | 46040.05 | 0.29 | 0.46 | 40663.07 | 16.22 | 0.00 | |
3 | Baseline + longitudinal | 46039.76 | 0.00 | 0.54 | 40646.85 | 0.00 | 1.00 | |
Anxiety | 1 | Null | 44524.35 | 24.61 | 0.00 | 39287.96 | 43.24 | 0.00 |
2 | Baseline | 44499.73 | 0.00 | 0.51 | 39260.88 | 16.16 | 0.00 | |
3 | Baseline + longitudinal | 44499.82 | 0.09 | 0.49 | 39244.72 | 0.00 | 1.00 | |
Hostility | 1 | Null | 45763.65 | 33.04 | 0.00 | 41923.67 | 36.12 | 0.00 |
2 | Baseline | 45731.09 | 0.48 | 0.44 | 41889.31 | 1.77 | 0.29 | |
3 | Baseline + longitudinal | 45730.61 | 0.00 | 0.56 | 41887.55 | 0.00 | 0.71 | |
Phobic anxiety | 1 | Null | 44385.08 | 21.60 | 0.00 | 38414.95 | 25.84 | 0.00 |
2 | Baseline | 44368.30 | 4.82 | 0.08 | 38405.41 | 16.30 | 0.00 | |
3 | Baseline + longitudinal | 44363.48 | 0.00 | 0.92 | 38389.11 | 0.00 | 1.00 | |
Paranoid ideation | 1 | Null | 41461.59 | 6.78 | 0.02 | 39364.64 | 13.05 | 0.00 |
2 | Baseline | 41454.81 | 0.00 | 0.64 | 39351.59 | 0.00 | 1.00 | |
3 | Baseline + longitudinal | 41456.09 | 1.28 | 0.34 | 39391.12 | 39.53 | 0.00 | |
Psychoticism | 1 | Null | 45879.04 | 29.96 | 0.00 | 40685.39 | 35.15 | 0.00 |
2 | Baseline | 45849.08 | 0.00 | 0.66 | 40653.05 | 2.81 | 0.20 | |
3 | Baseline + longitudinal | 45850.41 | 1.33 | 0.34 | 40650.24 | 0.00 | 0.80 |
Baseline Group Difference Relative to Controls | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Low | Medium | High | ||||||||||
Measure | Estimate | SE | t | p | Estimate | SE | t | p | Estimate | SE | t | p |
Participant | ||||||||||||
Global severity index | 2.54 | 1.14 | 2.23 | 0.026 | 4.89 | 1.03 | 4.74 | <0.001 | 4.32 | 1.02 | 4.24 | <0.001 |
Positive symptom total | 2.03 | 0.97 | 2.10 | 0.036 | 4.24 | 0.88 | 4.84 | <0.001 | 3.31 | 0.86 | 3.83 | <0.001 |
Positive symptom distress index | 3.15 | 0.92 | 3.43 | <0.001 | 3.55 | 0.83 | 4.26 | <0.001 | 2.76 | 0.82 | 3.36 | <0.001 |
Somatization | 2.81 | 1.19 | 2.36 | 0.018 | 5.81 | 1.08 | 5.38 | <0.001 | 6.02 | 1.07 | 5.65 | <0.001 |
Obsessive-compulsive symptoms | 2.24 | 1.12 | 2.01 | 0.045 | 3.46 | 1.01 | 3.42 | <0.001 | 3.94 | 1.00 | 3.95 | <0.001 |
Interpersonal sensitivity | 2.78 | 1.12 | 2.49 | 0.013 | 4.89 | 1.01 | 4.84 | <0.001 | 4.39 | 1.00 | 4.40 | <0.001 |
Depression | 2.08 | 0.94 | 2.20 | 0.028 | 4.14 | 0.85 | 4.87 | <0.001 | 3.94 | 0.84 | 4.71 | <0.001 |
Anxiety | 2.98 | 1.06 | 2.81 | 0.005 | 5.21 | 0.96 | 5.42 | <0.001 | 4.44 | 0.95 | 4.67 | <0.001 |
Hostility | 1.46 | 0.96 | 1.52 | 0.13 | 2.92 | 0.87 | 3.36 | <0.001 | 3.12 | 0.86 | 3.64 | <0.001 |
Phobic anxiety | 1.42 | 0.75 | 1.89 | 0.059 | 1.70 | 0.68 | 2.50 | 0.013 | 2.35 | 0.67 | 3.52 | <0.001 |
Paranoid ideation | 2.86 | 1.09 | 2.61 | 0.009 | 4.52 | 0.99 | 4.59 | <0.001 | 5.55 | 0.97 | 5.72 | <0.001 |
Companion | ||||||||||||
Global severity index | 0.87 | 1.07 | 0.81 | 0.417 | 3.59 | 0.97 | 3.71 | <0.001 | 3.21 | 0.95 | 3.38 | <0.001 |
Positive symptom total | 0.94 | 0.98 | 0.96 | 0.338 | 3.46 | 0.89 | 3.91 | <0.001 | 2.96 | 0.87 | 3.39 | <0.001 |
Positive symptom distress index | 0.64 | 0.95 | 0.67 | 0.504 | 3.09 | 0.87 | 3.56 | <0.001 | 2.80 | 0.85 | 3.29 | 0.001 |
Somatization | –0.35 | 0.84 | –0.42 | 0.674 | 1.14 | 0.76 | 1.50 | 0.134 | –0.18 | 0.74 | –0.25 | 0.804 |
Obsessive-compulsive symptoms | 1.56 | 1.08 | 1.45 | 0.148 | 4.09 | 0.98 | 4.18 | <0.001 | 5.18 | 0.96 | 5.40 | <0.001 |
Interpersonal sensitivity | 1.00 | 1.10 | 0.91 | 0.363 | 2.86 | 1.00 | 2.86 | 0.004 | 2.94 | 0.98 | 3.00 | 0.003 |
Depression | 0.80 | 1.08 | 0.74 | 0.460 | 3.51 | 0.98 | 3.56 | <0.001 | 3.53 | 0.97 | 3.65 | <0.001 |
Anxiety | 0.42 | 0.91 | 0.47 | 0.639 | 2.76 | 0.82 | 3.36 | <0.001 | 2.34 | 0.81 | 2.90 | 0.004 |
Hostility | 2.36 | 1.25 | 1.88 | 0.059 | 4.56 | 1.14 | 4.00 | <0.001 | 4.41 | 1.12 | 3.94 | <0.001 |
Phobic anxiety | 0.69 | 0.77 | 0.90 | 0.370 | 1.36 | 0.69 | 1.97 | 0.049 | 1.75 | 0.68 | 2.57 | 0.010 |
Paranoid ideation | 0.76 | 0.86 | 0.88 | 0.378 | 2.81 | 0.78 | 3.61 | <0.001 | 2.66 | 0.76 | 3.49 | <0.001 |
Psychoticism | 2.60 | 1.02 | 2.55 | 0.011 | 4.03 | 0.93 | 4.35 | <0.001 | 3.37 | 0.91 | 3.70 | <0.001 |
Group Difference Relative to Controls | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Low | Medium | High | ||||||||||
Measure | Estimate | SE | t | p | Estimate | SE | t | p | Estimate | SE | t | p |
Participant | ||||||||||||
Global severity index | 0.21 | 0.21 | 1.02 | 0.308 | 0.05 | 0.19 | 0.26 | 0.796 | 0.51 | 0.19 | 2.74 | 0.006 |
Positive symptom total | 0.27 | 0.17 | 1.54 | 0.124 | 0.06 | 0.16 | 0.35 | 0.73 | 0.49 | 0.16 | 3.10 | 0.002 |
Positive symptom distress index | –0.18 | 0.20 | –0.93 | 0.354 | –0.05 | 0.19 | –0.29 | 0.772 | 0.37 | 0.18 | 2.04 | 0.041 |
Somatization | 0.32 | 0.23 | 1.41 | 0.157 | 0.16 | 0.21 | 0.76 | 0.448 | 0.81 | 0.21 | 3.93 | <0.001 |
Obsessive-compulsive symptoms | 0.26 | 0.21 | 1.22 | 0.222 | 0.20 | 0.20 | 1.02 | 0.306 | 0.51 | 0.19 | 2.61 | 0.009 |
Interpersonal sensitivity | 0.11 | 0.21 | 0.51 | 0.613 | 0.07 | 0.20 | 0.37 | 0.714 | 0.42 | 0.19 | 2.19 | 0.028 |
Depression | –0.05 | 0.21 | –0.24 | 0.809 | –0.27 | 0.20 | –1.36 | 0.175 | 0.19 | 0.20 | 0.95 | 0.340 |
Anxiety | 0.13 | 0.19 | 0.67 | 0.506 | 0.26 | 0.18 | 1.43 | 0.153 | 0.55 | 0.18 | 3.08 | 0.002 |
Companion | ||||||||||||
Global severity index | 0.40 | 0.22 | 1.82 | 0.069 | 0.51 | 0.20 | 2.50 | 0.012 | 1.04 | 0.20 | 5.21 | <0.001 |
Positive symptom total | 0.45 | 0.19 | 2.35 | 0.019 | 0.48 | 0.18 | 2.69 | 0.007 | 1.08 | 0.18 | 6.14 | <0.001 |
Positive symptom distress index | 0.31 | 0.22 | 1.44 | 0.150 | 0.27 | 0.20 | 1.31 | 0.191 | 0.69 | 0.20 | 3.46 | <0.001 |
Somatization | 0.39 | 0.16 | 2.38 | 0.017 | 0.38 | 0.15 | 2.46 | 0.014 | 0.60 | 0.15 | 3.98 | <0.001 |
Obsessive-compulsive symptoms | 0.44 | 0.24 | 1.84 | 0.065 | 0.65 | 0.22 | 2.90 | 0.004 | 1.30 | 0.22 | 5.90 | <0.001 |
Interpersonal sensitivity | 0.09 | 0.22 | 0.42 | 0.672 | 0.23 | 0.20 | 1.16 | 0.246 | 0.70 | 0.20 | 3.50 | <0.001 |
Depression | 0.43 | 0.23 | 1.87 | 0.062 | 0.46 | 0.22 | 2.14 | 0.032 | 0.99 | 0.21 | 4.67 | <0.001 |
Anxiety | 0.27 | 0.19 | 1.42 | 0.155 | 0.36 | 0.18 | 1.99 | 0.047 | 0.81 | 0.18 | 4.54 | <0.001 |
Hostility | 0.08 | 0.26 | 0.32 | 0.749 | 0.29 | 0.24 | 1.20 | 0.230 | 0.59 | 0.24 | 2.49 | 0.013 |
Phobic anxiety | 0.16 | 0.20 | 0.79 | 0.430 | 0.29 | 0.19 | 1.56 | 0.118 | 0.79 | 0.18 | 4.31 | <0.001 |
Paranoid ideation | –0.12 | 0.23 | –0.50 | 0.619 | 0.17 | 0.22 | 0.78 | 0.435 | 0.47 | 0.22 | 2.18 | 0.029 |
Comparisons Between Participant and Companion Ratings
Measure | Control | Low | Medium | High |
---|---|---|---|---|
Global severity index | 0.43 | 0.27 | 0.55 | 0.80 |
Positive symptom total | 0.39 | 0.28 | 0.73 | 0.99 |
Positive symptom distress index | 0.45 | 0.54 | 0.28 | 0.28 |
Somatization | 0.67 | 0.33 | 0.51 | 0.40 |
Obsessive-compulsive symptoms | 0.27 | 0.28 | 0.89 | 0.90 |
Interpersonal sensitivity | 0.27 | 0.33 | 0.28 | 0.44 |
Depression | 0.50 | 0.28 | 0.30 | 0.75 |
Anxiety | 0.34 | 0.31 | 0.49 | 0.86 |
Hostility | 0.41 | 0.28 | 0.58 | 0.36 |
Phobic anxiety | 0.27 | 0.29 | 0.33 | 0.81 |
Paranoid ideation | 0.66 | 0.28 | 0.42 | 0.80 |
Psychoticism | 0.29 | 0.43 | 0.34 | 0.29 |
![](/cms/10.1176/appi.ajp.2015.14121551/asset/images/large/appi.ajp.2015.14121551f1.jpeg)
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