Journal of Genetic Counseling

, Volume 26, Issue 3, pp 435–441 | Cite as

The Confluence of Psychiatric Symptoms and Neurodegenerative Disease: Impact on Genetic Counseling

  • Jill S. Goldman
  • Edward D. Huey
  • Deborah Z. Thorne
Case Presentation


Hereditary neurodegenerative diseases can present with a psychiatric prodrome that overlaps with psychiatric symptoms that are not primary to these diseases. When individuals present for predictive testing while experiencing such symptoms, clinicians including genetic counselors, must proceed with caution and evaluate each situation on a case-by-case basis. Legitimate reasons may exist for moving forward with testing. Additionally predicting the consequences of testing is unrealistic so that the clinicians must do their best to prepare patients for both positive and negative results. A multidisciplinary team following the Huntington disease protocol remains the gold standard care for predictive testing for such patients. We discuss 3 case histories that demonstrate the complex nature of genetic counseling and testing in the presence of psychiatric symptoms, whether emanating from the disease itself or the results of living in an affected family.


Huntington disease Frontotemporal dementia Neurodegenerative disease Psychiatric symptoms Predictive testing 


Compliance with Ethical Standards

Conflict of Interest

Jill Goldman, Edward Huey, and Deborah Thorne declare that they have no conflict of interest.

Human Studies and Informed Consent

Identities of patients has been altered to protect confidentiality.


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Copyright information

© National Society of Genetic Counselors, Inc. 2016

Authors and Affiliations

  • Jill S. Goldman
    • 1
  • Edward D. Huey
    • 2
    • 3
  • Deborah Z. Thorne
    • 2
  1. 1.Taub InstituteColumbia University Medical CenterNew YorkUSA
  2. 2.Department of NeurologyColumbia University Medical CenterNew YorkUSA
  3. 3.Department of PsychiatryColumbia University Medical CenterNew YorkUSA

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