Huntington disease as a dual diagnosis disorder: Data from the national research roster for Huntington disease patients and families

Abstract

Although an extensive literature characterizes a linkage between primary mental illnesses and substance use disorders, a paucity of research exists concerning dual diagnosis phenomena in Huntington disease (HD). Data from the National Research Roster on HD suggest that higher levels of alcohol and cigarette use are associated with greater ratings of psychiatric symptoms and a younger age of HD symptom onset, and that progressive alcohol use after HD symptom onset is linked with worsening psychiatric symptom progression. These findings suggest HD entails dual diagnosis phenomena similar to that identified in patients with primary psychiatric disorders.

Reduced cancer incidence in Huntington's disease: record linkage study clue to an evolutionary trade‐off?

“…The reduction in cancer incidence in HD was seen despite the observation that smoking is more common in presymptomatic HD gene carriers (4). As well as implications for novel cancer prevention strategies, this finding may inform understanding of the evolutionary persistence of HD (5), and prompt wider consideration of similar 'trade-offs' between evolutionary gain and the risk of neurodegenerative diseases.…”

Varenicline improves motor and cognitive symptoms in early Huntington’s disease

“…No studies have directly investigated smoking in HD; however, previous literature suggests that a significant proportion of patients with HD (40%) are moderate or heavy smokers. 31 In the first patient we treated, varenicline was an effective smoking cessation aid. The contribution of nicotine withdrawal to the observed increase in irritability in this patient remains unclear.…”

Psychiatric and behavioural manifestations of Huntington's disease

“…Evidence is equivocal on the prevalence of substance use disorders in this population, a recent study (Ehret 2007) showing increased use of alcohol and cigarette smoking as psychiatric symptoms worsen, and increased use in those with early-onset Huntington's disease. Screening and treatment of comorbid substance misuse is appropriate.…”