Anxiety in Huntington’s Disease
Abstract
Methods
![](/cms/10.1176/appi.neuropsych.14100265/asset/images/large/appi.neuropsych.14100265f1.jpeg)
Results
Study | No. of Participants | Measure | Disease Duration (years), Mean (SD) [range] | Disease Stage | Country | Prevalence |
---|---|---|---|---|---|---|
Manifest HD | ||||||
Murgod et al. (2001)12 | 26 | UHDRS | 5.5 (3.9) [1–20] | 1–5 | India | 61.5% (point prevalence) |
Paulsen et al. (2005)8 | 2,835 | UHDRS | 7.6 (6.0) | 1–5 | U.S. | 41% (point prevalence) |
Craufurd et al. (2001)6 | 134 | PBA-HD | 9±5 [1–23] | 1–5 | UK | 37% (point prevalence) |
Thompson et al. (2012)15 | 111 | PBA-HD | 5.5 (4.7) | 1–5 at baseline | UK | 71% (cumulative prevalence at 3 years) |
Kulisevsky et al. (2001)17 | 29 | NPI | 5.6±1.6 | Not given | Spain/U.S. | 34% (point prevalence) |
Paulsen et al. (2001)18 | 52 | NPI | 4.7 (4.4) [1–20] | Not given | U.S. | 51.9% (point prevalence) |
Kristjanson et al. (2006)20 | 46 | HADS | 7.8 (4.8) | Not given | Australia | 41% (point prevalence) |
Arran et al. (2014)21 | 165 | HADS | Not given | Not given | UK | 48% point prevalence |
Leroi et al. (2002)26 | 21 | SCID | 12 (6.6) | Not given | U.S. | 24% (lifetime prevalence) |
Vassos et al. (2008)24 | 72 | SCID | 5.62 (5.7) | Not given | Greece | 12.5%, (point prevalence) |
16.7% (lifetime prevalence) | ||||||
van Duijn et al. (2008)25 | 85 | CIDI | Not given | Not given | Netherlands | 16.5% (12-month prevalence) |
Premanifest HD | ||||||
Berrios et al. (2001)28,a | 26 | CIDI | N/A | N/A | UK | 11.5% (point prevalence) |
STAI | ||||||
Berrios et al. (2002)29,a | 32 | CIDI | N/A | N/A | UK | 0% (point prevalence) |
STAI | ||||||
Shiwach and Norbury (1994) 31,a | 20 | PSE | N/A | N/A | UK | 0% (point prevalence) |
Julien et al. (2007)30,a | 89 | CIDI | N/A | N/A | UK | 15% (point prevalence) |
17% (lifetime) | ||||||
van Duijn et al. (2008)25,b | 55 | CIDI | N/A | Not given | Netherlands | 14.5% (12-month prevalence) |
All HD mutation carriers | ||||||
Reedeker et al. (2012)27 | 142 at baseline, | CIDI | Not given | 1–2 | Netherlands | 17% (2-year cumulative prevalence) |
106 at follow-up |
Group Comparisons | Noncarriers (N) | Premanifest HD (N) | Manifest HD (N) | Measure of Anxiety Used | Outcome |
---|---|---|---|---|---|
Manifest versus premanifest | |||||
Soliveri et al. (2002)23,s | — | 17 | 40 | HAM-A | Manifest>premanifest |
Marshall (2007)4,b | — | 49 | 34 | SCL-90 | NS |
van Duijn et al. (2008)25,a | — | 55 | 85 | CIDI | NS |
Manifest versus noncarrier,c | |||||
Soliveri et al. (2002)23,a | 28 | — | 40 | HAM-A | Manifest>noncarrier |
van Duijn et al. (2008)25,a | 56 | — | 85 | CIDI | NS |
Premanifest versus noncarrier | |||||
Shiwach and Norbury (1994)31,d | 33 | 20 | — | PSE | NS |
Rosenberg et al. (1995)55,d | 19 | 14 | — | SCL-90 R | NS |
Decruyenaere et al. (1995)56,d | Male=12 | Male=13 | — | STAI | Male carriers significantly less anxious than noncarriers, no difference for females. No analysis for total sample of males and females. |
Female=23 | Female=12 | ||||
Decruyenaere et al. (1996)22,c | 31 | 22 | — | STAI | NS at pretest and post-test |
Decruyenaere et al. (1999)44,c | 40 | 29 | — | STAI | NS at pretest and 1 year posttest |
Soliveri et al. (2002)23,a | 28 | 17 | — | HAM-A | NS |
Berrios et al. (2002)29,d | 66 | 32 | — | CIDI | NS |
Witjes-Ane et al. (2002)14,c | 88 at baseline, | 45 | — | UHDRS | NS at pretest and 18 months posttest |
78 at 18 months | 35 | ||||
Decruyenaere et al. (2003)45,c | 33 | 24 | — | STAI | NS pretest and 5 years posttest |
Duff et al. (2007)3,a | 92 | 589 | — | SCL-90 R | Premanifest>noncarrier |
Marshall et al. (2007)4,b | 171 | 49 | — | SCL-90 R | Premanifest>noncarrier |
Julien et al. (2007)30,d | 115 | 89 | — | CIDI | NS |
van Duijn et al. (2008)25,a | 56 | 55 | — | CIDI | NS |
Study | Participants (N) | Agoraphobia (%) | GAD (%) | Panic Disorder (%) | Simple Phobia (%) | Social Phobia (%) |
---|---|---|---|---|---|---|
Berrios et al. (2001)28,a | Pre-HD (26) | — | 3.8 | 7.7 | — | — |
Julien et al. (2007)30,a | Pre-HD (89) | 6 | 9 | 6 | 7 | 2 |
van Duijn et al. (2008)25,b | Pre-HD (55) | 1.8 | 5.5 | 3.6 | — | 5.5 |
HD (85) | 1.2 | 4.7 | 4.7 | 5.9 | ||
Reedeker et al. (2010)27 | All HD expansion carriers (142 at baseline, 106 at follow-up) | 2.8 | 5.7 | 5.7 | — | 7.5 |
Study | No. of Participants | Measure of Anxiety | Outcome |
---|---|---|---|
Jankovic et al. (1995)46 | 36 HD | UHDRS | Assessed impact of genetic testing and found no change in anxiety before and after testing |
Decruyenaere et al. (1996)22 | 22 pre-HD | STAI | No change in anxiety before and 1 year after genetic testing |
Levy et al. (1998)37 | 34 HD | NPI | Apathy did not correlate with anxiety. A relationship between anxiety and depression was found |
Decruyenaere et al. (1999)44 | 29 HD | STAI | No change in anxiety before and 1 year after genetic testing |
Craufurd et al. (2001)6 | 134 HD | PBA-HD | Anxiety loaded on to depression, but not irritability or apathy. No relationship was found between anxiety and duration of illness |
Paulsen et al. (2001)18 | 52 HD | NPI | Gender, age, apathy, illness duration, chorea severity, dementia severity, euphoria, disinhibition, and delusions did not correlate with anxiety. Agitation, irritability, and dysphoria did correlate with anxiety |
Witjes-Ane et al. (2002)14 | 35 pre-HD | UHDRS | Gender and age were not associated with anxiety. No change in anxiety 18 months after testing |
Decruyenaere et al. (2003)45 | 24 pre-HD | STAI | There was a significant reduction in trait anxiety 5 years after predictive testing and state anxiety 1 year and 5 years after testing |
Marshall et al. (2007)4 | 49 pre-HD | SCL-90 R | Premanifest HD carriers had more motor abnormalities. Although not reaching manifest HD, they had more anxiety than premotor symptomatic carriers with no or minor nonspecific motor abnormalities, but this finding did not reach significance |
Paulsen et al. (2005)8 | 2,835 HD | UHDRS | A higher level of anxiety was found in stage 2 disease than in other stages; after stage 2, a progressive decrease in anxiety was reported |
Julien et al. (2007)30 | 89 pre-HD | CIDI | Presence of anxiety disorders was not related to proximity to onset of manifest HD |
Kingma et al. (2008)38 | 152 all carriers | PBA-HD | Anxiety loaded onto depression factor, not irritability or apathy |
Zappacosta et al. (2008)32 | 29 HD | HAM-A | Anxiety correlated with depression but not with CAG repeats, motor ability, cognitive functioning, and duration of illness |
Leroi et al. (2002)26 | 21 HD | SCID | Anxiety was not associated with gender |
Vassos et al. (2008)24 | 72 HD | SCID | CAG repeats were not associated with anxiety |
McCabe et al. (2009)34 | 48 HD | POMS-SF | Anxiety-tension made a significant contribution to QoL |
Marder et al. (2010)35 | 960 HD | UHDRS | Anxiety loaded onto depression factor. Severity on the depression/anxiety factor of the UHDRS influenced the rate of decline on the Independence Scale |
Litvan et al. (1998)33 | 29 HD | NPI | Positive relationship between agitation/irritability and anxiety No relationship was found between the degree of chorea and anxiety |
Thompson et al. (2012)15 | 86 HD | PBA-HD | Did not find an increase in anxiety across stages of disease progression |
Wetzel et al. (2011)41 | 1941 HD | UHDRS | Depression/anxiety was found to significantly predict suicidal ideation and the top most 25% most severe suicidal ideation among the sample |
Soliveri et al. (2002)23 | 40 HD | HAM-A | Anxiety was associated with depression but not with CAG repeat length, motor ability, cognitive functioning, or disease duration |
Rickards et al. (2011)39 | 1803 HD | UHDRS | Support for a cluster of symptoms involving anxiety and depression was found in this factor analysis study |
Rickards et al. (2011)40 | 768 HD | HAM-D | Anxiety item on the HAM-D was not good at discriminating between HD patients who were or were not experiencing depressed mood |
Nimmagadda et al. (2011)36 | 30 HD | IDA, STAI | State and trait anxiety were associated with inward and outward irritability; state and trait anxiety correlated with depression |
Berrios et al. (2001)28 | 26 pre-HD | CIDI, STAI | No relationship between anxiety and CAG repeat length |
Hubers et al. (2013)43 | 2106 HD | UHDRS | Anxiety was independently associated with suicidal ideation at baseline, but during a 4-year period it was not predictive of suicidal ideation |
Fiedorowicz et al. (2011)42 | 735 pre-HD | PSS | Anxiety was not found to be an independent risk factor for suicidal behavior, defined as suicide or attempted suicide, across a mean of 3.7 years’ prospective follow-up |
Arran et al. (2014)21 | 165 HD | HADS | Anxiety was associated with pain, high number of symptoms, less strong belief in treatment control, and stronger belief in fluctuation of illness. Coping strategies associated with high anxiety were low acceptance, venting, self-blame, and behavioral disengagement |
Study | No. of Participants | Intervention | Methodology | Measure of Anxiety Used | Outcome |
---|---|---|---|---|---|
Murman et al. (1997)57 | 10 | Ketamine at 0.10, 0.40, and 0.60 mg/kg/hr | Double-blind, placebo-controlled, 1-day testing of increasing doses | BPRS and SRS | Nonsignificant |
Squitieri et al. (2001)48 | 10 | Olanzapine at 5 mg dose orally once per day | Open pilot, no control group, no blinding; 6-month intervention | UHDRS | Significant improvement at p=0.016 |
Lundin et al. (2010)58 | 28 treatment, 30 control, All manifest HD | Pridopidine at 50 mg/day | Randomized, double-blind, placebo-controlled 4-week trial | HADS | Nonsignificant trend for improvement |
A’Campo et al. (2012)47 | 29 HD with caregivers 12 pre-HD with partners | PEP-HD | Pilot study, no control group | HADS | Significant improvement at p=0.05 for manifest HD Nonsignificant for premanifest HD |
Piira et al. (2013)49 | 37 | Intensive multidisciplinary program | Pilot study, no control group | HADS | Significant improvement at p=0.001 |
Prevalence and Group Comparison Studies
HD-specific measures.
General symptomatology measures of anxiety.
Diagnostic measures.
Prevalence of individual anxiety disorders.
Correlates and Predictors
Sociodemographic and Clinical
Psychiatric
Psychological Variables
Intervention
Discussion
Acknowledgments
References
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