Huntington’s Patients with Low Perceived Psychological Distress May Have Weaker Social Cognitive Skills

Patients with Huntington’s disease with low levels of perceived psychological distress may have weaker social cognitive skills, according to a new study.

However, researchers think that this association (self-reporting of psychological distress and social cognitive test performance) may be due to apathy and/or impaired insight, which are common in this disease.

The study, “Social Cognition, Executive Functions And Self-Report Of Psychological Distress In Huntington’s Disease,” was published in the journal PLoS Currents: Huntington’s Disease.

Pre-symptoms and early stages of Huntington’s disease may be associated with a wide variety of psychiatric symptoms such as apathy, depression, irritability, anxiety, mania, and obsessive compulsive disorder.

“Performance on tests of social cognition and executive functions are often affected by psychopathology,” researchers wrote. “Associations between social cognitive functions, executive functions, and psychiatric symptoms have been investigated in both psychiatric and neurological disorders … The most common finding being that greater degree of psychiatric symptoms are associated [with] worse performance on tests of executive functions and social cognition.”

Previous studies of Huntington’s patients in early-moderate disease stages showed they often performed abnormally on tests of executive functions and social cognition. Researchers decided to investigate whether these poor performances were associated with psychiatric symptoms and psychological distress.

The study enrolled 50 Huntington’s disease patients who were tested with measures of social cognition and executive function. They were also asked to complete a questionnaire on their perceived status of psychological distress (the Symptom Checklist-90-Revised, SCL-90-R).

Researchers then compared the results of the different measures to find correlations between psychological distress and social cognition and executive functions.

They found that patients reporting low psychological distress had significantly worse performances on social cognitive tests regardless of factors such as age, Unified Huntington’s Disease Rating Scale-99 total motor score, or performance on executive functions tests.

In fact, no significant correlation was found between perceived psychological distress and performance on executive functions tests.

“We found significant associations between self-report of psychological distress and performances on social cognitive tests but not on tests of executive functions,” researchers wrote. “According to our findings, [Huntington’s] patients that feel less psychologically distressed themselves perform worse on tests of the ability to recognize emotions, [mental states] and sarcasm in others. This is an interesting finding that may be of importance for understanding the interpersonal problems often associated with [Huntington’s].”

They also noted that self-reports of psychological distress may have been influenced by poor insight associated with Huntington’s disease. This means that the psychological distress reported by the patients may not be clinically accurate and that poor social cognition may not necessarily be associated with fewer psychiatric symptoms in this group pf patients.

Indeed, researchers speculated that “a flattening of affect or apathy and impaired insight has led to low self-report of psychological distress in our cohort and that this was related to the weaker understanding of others (i.e. poor social cognitive skills including emotion recognition).”