Psychiatric Disorders and Apathy in Mixed Movement Disorders Linked to ADCY5 (MxMD-ADCY5)

Background: Mixed movement disorders linked to ADCY5 (MxMD-ADCY5) represent a rare hyperkinetic movement disorder resulting from pathogenic variants in ADCY5. Psychiatric symptoms are suspected to be part of the phenotype. Objective: The study aim was to assess psychiatric comorbidities in patients with MxMD-ADCY5. Methods: Consecutive patients were assessed with the MINI International Neuropsychiatric Interview (MINI), the shortened Beck Depression Inventory (BDI-13), the Hospital Anxiety and Depression Scale (HADS), and the Starkstein Apathy Scale (SAS). Results: Twenty-seven patients and 20 controls were included. Psychiatric disorders were present in 67% of patients compared with 15% of controls (P = 0.00043), mainly anxiety (33% vs. 0%, P = 0.00862) and depression (44% vs. 10%, P = 0.01068). Depression, anxiety, and apathy scores were higher in patients (BDI-13: 3.67 vs. 1.05, P = 0.004; HA: 6.71 vs. 3.90, P = 0.006; AS: 11.67 vs. 6.85, P = 0.001). Conclusion: Depression, anxiety, and apathy are likely part of the phenotypic spectrum of MxMD-ADCY5. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.