Relationships with people with Huntington’s disease and their relatives: the personal experiences of nursing staff at a specialist locked inpatient UK hospital

Harding, Vincent Jonathon (2021). Relationships with people with Huntington’s disease and their relatives: the personal experiences of nursing staff at a specialist locked inpatient UK hospital. University of Birmingham. Foren.Clin.Psy.D.

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Abstract

Background: Huntington’s disease (HD) is a relatively rare hereditary progressive neurodegenerative condition. Amongst motor and cognitive symptoms, irritability often occurs in people with HD (pwHD) and can lead to aggression. Both are associated with increased hospital admissions and harmful effects on everyday functioning and quality of life. Aggression may pose a risk to the pwHD themselves as well as other people.

Aims and objectives: Very few reviews have explored irritability and/ or aggression. Those that have are weakened by methodological shortcomings. They are not systematic, do not represent full coverage of existing studies, nor do they reference the importance of ensuring that the measure of irritability or aggression is valid and reliable. This review set out to consolidate and assess the quality of research exploring the most efficacious known interventions for irritability and aggression for pwHD.

Method: EMBASE, PsycINFO, and Web of Science were systematically searched in September 2020. These electronic databases were selected because they covered psychology, psychiatry, and health care interventions. A narrative synthesis was used due to there being high levels of methodological heterogeneity.

Results: A systematic review of the literature identified 12 studies outlining treatment for pwHD and irritability and/ or aggression meeting the inclusion criteria. The studies included spanned 20 years between 1997 and 2017. They contained high levels of methodological heterogeneity, including both randomised and non-randomised methods, sampling men and women across the world, in inpatient and outpatient settings, and with symptomatic or pre-symptomatic HD. The sample sizes included small, moderate, and large participant groups. The studies included pharmacological treatments of irritability and aggression in HD as well as alternative psychological treatments.

Conclusion: There was some support for the use of atypical antipsychotics, cannabinoids, selective serotonin reuptake inhibitors, and non-pharmacological treatments for irritability and/ or aggression in pwHD. However, several methodological shortcomings must be borne in mind when evaluating the robustness of the synthesis. Further research should be conducted to address these shortcomings.

Type of Work:

Thesis (Doctorates > Foren.Clin.Psy.D.)

Award Type:

Doctorates > Foren.Clin.Psy.D.

Supervisor(s):