October 5, 2021

Breaking bad with Huntington’s disease

Illegal activities are a significant clinical problem in individuals with Huntington’s disease, highlighting the need for improved screening measures and protocols to guide patient management.

by Paul Govern

Analyses of police records and criminal conviction databases have revealed associations between Huntington’s disease (HD) and unlawful behavior. In the Journal of the American Academy of Psychiatry and the LawKatherine McDonell, MD, and colleagues report the first investigation of criminal behavior in a large clinical population with HD.   

Huntington’s is an inherited neurodegenerative disease typically manifesting in midlife, with mood and cognition problems being the earliest symptoms. The report is based on chart review of 282 patients with HD treated at Vanderbilt University Medical Center between 2006 and 2020. 

Some 11% of these patients had a documented history of criminal behavior in their medical record: physical violence, reckless driving, substance abuse, illegal financial activity, inappropriate sexual behavior.

Noting that this finding is apt to underestimate the true prevalence of criminal behavior in these patients, the authors highlight the complex nature of HD and call for an interdisciplinary approach to patient management based on a careful understanding of the unique vulnerabilities of this population.

Others on the study include Brittany Brown, Lisa Hale, LMSW, R. Ryan Darby, MD, Jeffrey Stovall, MD, Bruce Compas, PhD, and Daniel Claassen, MD.