There is no cure for the disease, and there is a high rate of neuropsychiatric symptoms including depression, and aggressive behavior.
A common and particularly detrimental neuropsychiatric alteration in HD gene carriers is irritability, which frequently manifests as abrupt and unpredictable outbursts of anger.
Behavioural changes are often the first symptoms of Huntington's disease. These changes often include: a lack of emotions and not recognising the needs of others. periods of aggression, excitement, depression, antisocial behaviour and anger.
People with Huntington's may also be less able to control their emotions, possibly leading to outbursts of screaming, swearing, slamming doors, hitting walls, or the like. Patterns of behavior can change as the disease progresses.
Early symptoms
memory lapses. depression – including low mood, a lack of interest in things, and feelings of hopelessness. stumbling and clumsiness. mood swings, such as irritability or aggressive behaviour.
HD patients present a broad range of psychological disturbances such as cognitive rigidity, mood disturbances, lack of empathy and breakdowns of social relationships that might also manifest even before the onset of motor dysfunction (Marvel and Paradiso, 2004).
The early symptoms of Huntington disease are often general: Irritability. Depression. Mood swings.
During the disease progression, the Huntington's patient experiences a steady deterioration in mental and physical capabilities, including: Forgetfulness and impaired judgment. Mood swings and depression. Noticeable changes in personality.
As the disease progresses, a variety of motor, emotional/behavioral, and cognitive symptoms are experienced, including unsteadiness, trouble holding onto things, trouble walking, changes in sleeping patterns, delusions and hallucinations, intellectual decline, and memory loss.
The time when symptoms actually show up varies between people, however. There is evidence that about 40% of this variation is due to other genetic factors, and about 60% is due to unknown influences in a person's life or surroundings - which scientists refer to as environmental factors.
Surprisingly, many people with Huntington's disease aren't aware that the involuntary movements are happening, or don't notice them as much as other people do. That's because Huntington's disease can affect people's awareness of their own bodies.
Weight loss can make symptoms worse and weaken the patient's immune system, making them more vulnerable to infections and other complications. Huntington's disease itself is not usually fatal, but it can lead to choking, pneumonia, or other infections that can lead to death.
The most painful conditions in Huntington's, said Achterberg, are limb pain, headache, abdominal pain and fractures. “I think we should do more work in validation of pain tools, including observational pain instruments,” he said. “And for clinicians, I suggest you be especially aware of abdominal pain.”
Stage 4: Early advanced stage
Typically lasting between nine and 21 years from disease onset, the early advanced stage is characterized by a need for full assistance in daily living. A person in this stage of Huntington's cannot live independently.
Huntington's Disease (HD) is not fatal in itself. People with HD have a shorter life expectancy and die of other life-threatening complications related to this disease. Pneumonia and heart disease are the two leading causes of death for people with HD.
After Huntington's disease starts, a person's functional abilities gradually worsen over time. The rate of disease progression and duration varies. The time from the first symptoms to death is often about 10 to 30 years. Juvenile Huntington's disease usually results in death within 10 years after symptoms develop.
Huntington's disease impairs the functioning of the brain, which can result in apathy, trouble organizing, impulsivity, irritability and anger, unawareness, disinhibition, preservation, and other psychiatric symptoms. These emotional and behavioral symptoms can further complicate the caregiver's role.
In Australia it is estimated that over 1,800 people have Huntington's Disease and approximately 9,000 are at risk (Huntington's NSW ACT website, 2019) with a reported prevalence rate in Australia which ranges from 4.5 per 100,000 to 6.5 per 100,000 (Pringsheim et al., 2012).
Categorizing Psychiatric Issues in HD
The first consists of mental illnesses which are common in the general population and are readily recognized by physicians, especially major depression, which has been estimated to affect 40% of people with HD at some point during their illness.
Of the troubling behavioral changes that occur with the onset of Huntington's disease (HD) and Juvenile Huntington's disease (JHD), and there are many, one of the most troublesome can be hypersexuality.
Huntington's disease (HD) commonly presents with impaired social functioning. Specifically, many patients exhibit social withdrawal, or decreased engagement in social activities.
Although stress does not play a direct role in the onset and development of Huntington´s disease (HD) itself, it does have an influence on the course of the disease.