Neurologisch-psychiatrischer status von risikopersonen fur chorea Huntington

The possibility of predictive testing for Huntington disease has raised questions about ethical and social problems. As a consequence, practical guidelines for this test have been published, which include a neurological examination and psychological assessment. The form of the psychological support depends on the needs of the individual person at risk. Therefore, we prospectively examined 41 persons at risk for Huntington disease in a fixed setting of a multidisciplinary team including genetecist, psychologist and neurologist. Nineteen of the 31 persons, who have been eventually tested, carried the gene for Huntington disease. Of these, 16 were symptomatic at the time of testing. Besides choreatic movements and electrophysiological reflex abnormalities, they presented with changes of personality, affect, or thinking. We therefore propose that an insight-oriented psychotherapy for symptomatic persons at risk as a prerequisite for genetic testing is less helpful than an intensive psychological counseling focussed on personal and familial resources.