Background and Aims:
Huntington’s disease is an autosomal dominant neurodegenerative disorder characterized by a triad of symptoms consisting of cognitive impairment, motor disturbances and psychiatric features. Studies have shown that psychiatric manifestations often precede the motor signs of the disease by sometimes even more than a decade. 
This study aims to report a series of 5 patients with genetic diagnosis of Huntington’s disease and to describe preclinical and clinical neuropsychiatric manifestations.
Methods:
The authors reviewed medical records of 5 patients seen in the psychiatric departments, and have used  PubMed for a systematic literature review on the topic.
Results:
The 5 patients studied consisted of 2 males and 3 females all with a family history of Huntington’s two of the patients being relatives ( father and daughter). Aside from one patient who presented with juvenile Huntington’s disease and early onset of choreiform movements and cognitive impairment all other 4 patients presented with psychiatric pre-clinical manifestations consisting of: insomnia, anxiety, depression, restlessness, irritable mood and mild psychotic symptoms that much preceded the motor involvement of the disorder.
Conclusions:
Psychiatric symptoms are prevalent in Huntington’s and are relatively independent of the motor and cognitive symptoms of the disease and their progression. In the majority of the cases psychiatric symptoms preceded the onset of the other symptoms by years. Gaining better understanding of the symptoms is essential as these have strong implications for disease management, prognosis and quality of life.

NEUROPSYCHIATRIC SYMPTOMS IN HUNTINGTON’S DISEASE- 5 CASE SERIES