Highlighting the Psychiatric Burden: Depression and Anxiety Drive Poor Quality of Life in Focal Dystonia.

INTRODUCTION

Primary focal dystonias are movement disorders linked to dysfunctions in the basal ganglia, which also play a role in neuropsychiatric conditions. While motor symptoms in dystonia are well-documented, the neuropsychiatric comorbidities associated with these disorders, particularly depression, anxiety, obsessive-compulsive disorder (OCD), psychosis and pain, have been little explored. This study aims to assess the prevalence of these psychiatric disorders and their impact on the quality of life (QoL) in patients with cervical dystonia (CD) and oromandibular dystonia (OMD).

METHODOLOGY: A total of 140 patients with primary CD and OMD, along with 71 age- and gender-matched healthy controls, were recruited for this study. Participants underwent clinical assessments using the Fahn-Marsden Dystonia Rating Scale, Toronto Western Spasmodic Torticollis Rating Scale and Oromandibular Dystonia Questionnaire for dystonia severity. Psychiatric comorbidities were screened using the Mini International Neuropsychiatric Interview and assessed with rating scales for depression, anxiety, OCD and psychosis. QoL was evaluated using the World Health Organization Quality Of Life - BREF (WHOQOL-BREF).

RESULTS

The results showed significantly higher rates of depression (37.9%) and anxiety (29.3%) in patients with dystonia compared to healthy controls (9.9% and 7%, respectively). Both mood disorders were correlated with the severity of dystonia and self-reported pain. The QoL in dystonia patients was significantly worse in the physical and psychological domains.

CONCLUSION

Psychiatric comorbidities, particularly depression and anxiety and pain, are highly prevalent in patients with primary CD and OMD, significantly impacting their QoL.