Using a clinical formulation to understand psychological distress in people affected by Huntington’s disease: A descriptive, evidence-based model

Maria Dale, Ashleigh Wood, Nicolò Zarotti, Fiona Eccles, Sarah Gunn, Reza Kiani, Amanda Mobley, Noelle Robertson, Jane Simpson

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
1 Downloads (Pure)


Huntington’s disease (HD) is an inherited, life-limiting neurodegenerative condition. People with HD experience changes in cognitive, motor and emotional functioning, and can also, mainly at later stages, exhibit behaviours that professionals and carers might find distressing such as hitting others, throwing objects, swearing or making inappropriate comments. While clinical formulation (an individualised approach used by mental health professionals to describe an individual’s difficulties) is a helpful tool to conceptualise patients’ wellbeing, a specific formulation framework has not yet been developed for HD. However, evidence has shown that formulation can help guide clinical interventions and increase consistency of approach across multi-disciplinary teams, refine risk management, and improve staff or carers’ empathic skills and understanding of complex presentations. As a consequence, this paper proposes a new clinical formulation model for understanding distress among people with HD, based on a biopsychosocial framework. More specifically, this includes key elements centring on an individual’s past experience and personal narratives, as well as anticipatory cognitions and emotions about the future. In-depth discussions regarding the components of the model and their importance in HD formulations are included, and a fictional yet representative case example is presented to illustrate their application within the context of personalised care.
Original languageEnglish
Article number1222
JournalJournal of Personalized Medicine
Issue number8
Early online date27 Jul 2022
Publication statusPublished - Aug 2022


  • Huntington’s disease
  • formulation
  • challenging behaviour
  • biopsychosocial
  • psychological distress

Cite this