School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton, VIC, 3800, Australia.
Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia.
J Neurol. 2024 Jan;271(1):289-299. doi: 10.1007/s00415-023-11982-x. Epub 2023 Sep 11.
Huntington's disease (HD) is an inherited neurodegenerative disease involving motor abnormalities, cognitive decline, and psychological difficulties. Depression is among the most common psychological difficulties in HD. People with HD encounter numerous stressors related to their diagnosis and the impact of HD on their daily lives. Understanding the relationship between HD-specific psychosocial stressors and depression symptoms is critical for optimising treatment and developing a holistic, disease-specific model of depression in HD.
Fifty-seven adults with the HD gene expansion (33 pre-symptomatic, 24 symptomatic) completed a self-report depression questionnaire and rated how much stress they experienced in relation to 20 psychosocial challenges commonly associated with HD. We examined associations between depression symptoms and each stressor individually, and after clustering using principal components analysis.
Depression symptoms were significantly associated with most of the psychosocial stressors assessed. Clustering with principal components analysis revealed that higher depression scores had significant independent associations with greater stress related to the future implications of HD (β = .44, p = .001) and sleep and psychological difficulties (β = .28, p = .005), but not with stress related to functional limitations (β = .11, p = .33) or interpersonal issues caused by HD (β = .15, p = .21).
Stressful experiences associated with HD constitute an important risk factor for depression in HD. Our findings support the use of more psychologically informed models of depression in HD and necessitate further research on tailored psychosocial interventions for HD patients with depression.
亨廷顿病(HD)是一种遗传性神经退行性疾病,涉及运动异常、认知能力下降和心理困难。抑郁症是 HD 最常见的心理问题之一。HD 患者会遇到与诊断相关的许多压力源,以及 HD 对日常生活的影响。了解 HD 特定的心理压力源与抑郁症状之间的关系对于优化治疗和制定 HD 抑郁的整体、特定疾病模型至关重要。
57 名携带 HD 基因突变的成年人(33 名无症状前患者,24 名有症状患者)完成了一份抑郁自评问卷,并对与 20 种与 HD 相关的常见心理社会挑战相关的压力源进行了评分。我们分别检查了抑郁症状与每个压力源之间的关联,并使用主成分分析进行聚类后进行了检查。
抑郁症状与评估的大多数心理社会压力源显著相关。主成分分析聚类显示,较高的抑郁评分与 HD 未来影响(β=0.44,p=0.001)、睡眠和心理困难(β=0.28,p=0.005)相关的压力显著独立相关,与功能障碍(β=0.11,p=0.33)或由 HD 引起的人际问题(β=0.15,p=0.21)相关的压力无关。
与 HD 相关的压力体验是 HD 抑郁的一个重要危险因素。我们的研究结果支持在 HD 中使用更具心理洞察力的抑郁模型,并需要进一步研究针对 HD 伴抑郁患者的定制心理社会干预措施。