F072 Prevalence, characteristics and correlates of violent and criminal behavior in Huntington disease

<h3>Background</h3> Frontal-related behavioral and cognitive symptoms, including perseveration, irritability and executive dysfunction, are characteristics of Huntington’s disease (HD). Although these symptoms can lead to maladaptive and reckless behaviors, few studies have delved into the prevalence, correlates and phenomenology of violent and criminal behavior in HD. <h3>Methods</h3> We studied a cohort of 115 gene-mutation carriers (n=83 HD and n=32 preHD) with a 45-item interview covering Verbal Violence (VV), Physical Violence (PV), Sexual behavior (SB) and Criminal behavior (CB), in parallel with clinical and neuropsychiatric assessment. Paraphilias with a violent nature were also recorded. Frequency of symptom occurrence and its current or past presence was rated. The interview was administered to a reliable informant in HD and to participants with a partner in preHD. <h3>Results</h3> Prevalence of violent behavior was 37.4% [HD=33.9% vs preHD=3.5%; x2=11.7;p=0.001). The most prevalent was VV (34.8%), followed by PV (17.4%), SB (7%) and CB (4.7%). The frequency was 4-to-7 days/week. Behaviors were already present in the past in 85% of the HD cases, and persisted in 50%. PreHD associated a lower prevalence of violent behavior in the past. Only one case was sexual abuse and two were violent paraphilias. VV and PV (past and present) were associated with higher PBAs irritability (r=0.534; p&lt;0.0001), aggression (r=0.434; p&lt;0.0001), OCB (r= 0.321; p=0.001) and perseveration (r=0.251; p=0.009) severity. <h3>Conclusions</h3> Verbal and physical violence is significantly increased in HD and is associated with the severity of several frontal-related neuropsychiatric symptoms. Criminal behavior and sexual abuse are not increased in this population.