Psychiatric comorbidities in cases with Duchenne muscular dystrophy: a case series

Duchenne muscular dystrophy is a hereditary multisystem disease caused by mutations in the dystrophin gene, characterized by proximal muscle weakness in early childhood, generally resulting in death before the age of 20 years. Cognitive and neurobehavioral changes are prevalent in Duchenne muscular dystrophy. Furthermore, psychiatric disorders have been reported. Here we present 12 cases with Duchenne muscular dystrophy, aiming to address psychiatric comorbidities and to examine anxiety and depression levels as well as the quality of life in these cases. Twelve inpatients with Duchenne muscular dystrophy were followed, according to their ages, by an adult psychiatrist or a child and adolescent psychiatrist. Psychiatric examination and detailed psychiatric and medical history-taking were performed. The Hospital Anxiety and Depression Scale (HADS) and the KINDL Questionnaire were administered and family interviews conducted. In 5 cases, comorbid psychiatric diagnoses were present, including depression, obsessive compulsive disorder, and generalized anxiety disorder. Anxiety levels according to the HADS were higher than threshold level in two cases. Alongside cognitive and neurobehavioral changes, psychiatric comorbidities such as depression, obsessive compulsive disorder, or generalized anxiety disorder might be seen in Duchenne muscular dystrophy, as was the case with our patients. At the same time, due to the chronic illness process and disability involved, psychosocial support is needed both for the patient and the family. Therefore, it is important that psychiatry should be part of a holistic treatment approach and that psychiatric support should be provided right from the first years in these cases.