Background Depression and anxiety are common in HD. A consistent finding among the general population is that women are more likely to experience anxiety and depression than men. There is some evidence of increased depression among women with HD, though results are mixed, and relatively little is known about anxiety in HD.

Aims To examine gender influence on depression and anxiety using the Hospital Anxiety and Depression scale (HADS) by disease stage and to explore whether there are gender differences among those who are pre-motor symptomatic for HD.

Methods/techniques A cross-sectional study using Registry 3 data was undertaken, using the Hospital Anxiety and Depression scale (HADS). Data was analysed according to disease stage, determined by TFC score. Those who were pre-motor symptomatic for HD were also examined for gender differences.

Results/outcome A significant gender difference (p = 0.016) was found for total HADS score among a pre-motor symptomatic HD sample (n = 86), with females demonstrating greater psychological distress than males. No significant gender difference in total HADS score was revealed among the motor symptomatic HD participants (n = 410) or across the entire sample of HD expansion carriers (n = 496). Across all HD expansion carriers (n = 504), females reported significantly higher levels of anxiety (p = 0.031). Among the pre-motor symptomatic HD sample, females reported significantly higher levels of anxiety than males (p = 0.02), but no significant gender difference in anxiety levels was found among the motor symptomatic HD group. No significant gender difference in depression levels were found across all groups of HD expansion carriers. Analysis of the data by disease stage revealed no significant gender differences in anxiety and depression.

Conclusions Gender differences in anxiety and overall psychological distress were apparent in pre-motor symptomatic HD, but these diminished in the motor symptomatic group.