ADVERSE PSYCHOLOGICAL EVENTS OCCURRING IN THE FIRST YEAR AFTER PREDICTIVE TESTING FOR HUNTINGTONS-DISEASE

A total of 135 participants in the Canadian predictive testing program me for HD were followed for at least one year in one of four study gro ups: increased risk (n=37), decreased risk (n=58), uninformative (n=17 ), or not tested (n=23). Clinical criteria for an adverse event were a suicide attempt or formulation of a suicide plan, psychiatric hospita lisation, depression lasting longer than two months, a marked increase in substance abuse, and the breakdown of important relationships. Qua ntitative criteria, as measured by changes on the General Severity Ind ex of the Symptom Checklist 90-R and the Beck Depression Inventory, we re also used to identify people who had adverse events. Twenty of the 135 participants (14.8%) had an adverse event. There were no significa nt differences between those with or without an adverse event with res pect to age, sex, marital status, education, psychiatric history, gene ral psychiatric distress, or social supports at baseline. However, evi dence for depression was associated with an increased frequency of adv erse events (p<0.04). The adverse events were similar and seen with eq uivalent frequency in those receiving an increased risk or decreased r isk and persons at risk who did not receive a modification of risk. Ho wever, a significant difference was found in the timing of adverse eve nts for the increased and decreased risk groups (p<0.0002). In the inc reased risk group all of the adverse events occurred within 10 days af ter results whereas, in the decreased risk group, all of the adverse e vents occurred six months or later after reviewing test results. These results suggest that people entering into predictive testing with som e evidence of clinical depression warrant special vigilance and also s uggest that counselling and support should be available for all partic ipants in predictive testing irrespective of the direction of test res ults.