Huntington's disease and psychiatric comorbidity

Abstract

Purpose: To examine the prevalence and impact on outcomes of psychiatric comorbidity among Huntington's disease (HD) patients hospitalized in Portugal between 2000 and 2016. Methods: A retrospective observational study was conducted using administrative data from Portuguese public hospitals within the National Health Service (SNS) between 2000 and 2016. All hospitalization episodes of patients with a diagnosis of HD (ICD-9-CM code 333.4) were analysed. Comorbid psychiatric diagnosis registered as primary or secondary diagnosis were identified and defined using the HCUP Clinical Classification Software (CCS) codes 650-670. Age at admission, length of hospital stay (LoS), admission type, in-hospital mortality and estimated hospital charges were analysed according to psychiatric comorbidity categories and adjusting for age and sex. Results: A total of 1667 hospitalizations with a diagnosis of HD occurred between 2000 and 2016, of which 28.97% had psychiatric comorbidity. These patients were more likely to be younger (aOR = 1.32, 95% CI 1.07-1.64; p = 0.011) and to have longer LoS (aOR = 1.88, 95% CI 1.52-2.34; p < 0.001) than those with no psychiatric comorbidity. No association was found between psychiatric comorbidity in general and in-hospital mortality, admission type or hospitalization costs. An upward trend was observed in HD admissions and percentage of those with psychiatric comorbidity over the study period. Conclusion: Psychiatric comorbidity in HD is associated with younger age at admission and longer hospitalizations. These results highlight the importance of psychiatric care in the management of these patients. Early screening and intervention could improve outcomes and optimize healthcare resource allocation.