Format

Send to

Choose Destination
J Neurol Neurosurg Psychiatry. 2017 Jul;88(7):595-602. doi: 10.1136/jnnp-2016-315461. Epub 2017 Apr 24.

Psychiatric associations of adult-onset focal dystonia phenotypes.

Author information

1
Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
2
Neurology Section, VA Eastern Colorado Health Care System, Denver, Colorado, USA.
3
Institute of Neurogenetics, University of Luebeck, Luebeck, Germany.
4
Department of Neurology, University of Luebeck, Luebeck, Germany.
5
Department of Neurology, Emory University, Atlanta, Georgia, USA.
6
Departments of Neurology, Radiology, Neuroscience, Physical Therapy and Occupational Therapy, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA.
7
Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA.
8
Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
9
Département de neurologie, Hôpital Pitié-Salpêtrière, Assistance Publique - Hopitaux de Paris, Paris, France.
10
UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, UM 75, ICM, F-75013, Sorbonne Universites, Paris, France.
11
Department of Neurology, Houston Methodist, Houston, Texas, USA.
12
Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA.
13
Department of Internal Medicine, University of Central Florida, Orlando, Florida, USA.
14
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA.
15
Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA.
16
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
17
Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, Lübeck, Germany.

Abstract

BACKGROUND:

Depression and anxiety frequently accompany the motor manifestations of isolated adult-onset focal dystonias. Whether the body region affected when this type of dystonia first presents is associated with the severity of these neuropsychiatric symptoms is unknown.

OBJECTIVES:

The aim of this study was to determine whether depression, anxiety and social anxiety vary by dystonia onset site and evaluate whether pain and dystonia severity account for any differences.

METHODS:

Patients with isolated focal dystonia evaluated within 5 years from symptom onset, enrolled in the Natural History Project of the Dystonia Coalition, were included in the analysis. Individual onset sites were grouped into five body regions: cervical, laryngeal, limb, lower cranial and upper cranial. Neuropsychiatric symptoms were rated using the Beck Depression Inventory, Hospital Anxiety and Depression Scale and Liebowitz Social Anxiety Scale. Pain was estimated using the 36-Item Short Form Survey.

RESULTS:

Four hundred and seventy-eight subjects met our inclusion criteria. High levels of depression, anxiety and social anxiety occurred in all groups; however, the severity of anxiety and social anxiety symptoms varied by onset site group. The most pronounced differences were higher anxiety in cervical and laryngeal, lower anxiety in upper cranial and higher social anxiety in laryngeal. Increases in pain were associated with worse neuropsychiatric symptom scores within all groups. Higher anxiety and social anxiety in laryngeal and lower anxiety in upper cranial persisted after correcting for pain and dystonia severity.

CONCLUSION:

Anxiety and social anxiety severity vary by onset site of focal dystonia, and this variation is not explained by differences in pain and dystonia severity.

KEYWORDS:

Isolated focal dystonia; anxiety; depression; pain

PMID:
28438790
PMCID:
PMC5659143
DOI:
10.1136/jnnp-2016-315461
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center