Background Huntington’s disease (HD) is a genetic neurodegenerative disease that usually develops in mid-adulthood and is characterised by cognitive decline, motor disorder and emotional changes. Anxiety and depression are common in HD and often precede the movement disorder.

Aims To examine anxiety and depression in pre-motor symptomatic HD expansion carriers, and motor-symptomatic patients across disease stages, using the HADS.

Methods/techniques A cross-sectional study of HADS data from the REGISTRY 3 study was examined (n = 496). Clinical caseness (scores of ≥ 8 on anxiety or depression subscales) was examined, as well as total HADS and subscale scores. Pre-motor symptomatic participants were compared with those who were motor symptomatic. Anxiety and depression were examined according to disease stage. The relationship between HADS scores and other disease variables was explored.

Results/outcome The motor-symptomatic group (n = 410) scored significantly higher on total HADS and both subscales than the pre-motor symptomatic group (n = 86). While clinical levels of depression were also higher among the motor symptomatic group (41%) compared to the pre-motor symptomatic group (10.5%), clinical levels of anxiety were not significantly different between the motor-symptomatic group (28.5%) and pre-motor symptomatic group (25.3%). Total HADS scores and subscales revealed a linear increase across disease stages. A significant relationship was found between HADS scores and cognitive and motor scores, but not with disease duration.

Conclusions These results indicate that further understanding of the relationship between anxiety and depression in HD may increase our knowledge of the psychiatric aspect of the disease. Furthermore, the HADS data appears more closely aligned to disease progression than previous studies of anxiety and depression have found. Further study of this instrument in HD is warranted.