Reduced distress tolerance and elevated depression in functional tremor: A comparative cross-sectional observational study of tremor disorders.

BACKGROUND

Patients with Parkinson's Disease (PD) frequently experience depression and anxiety, while those with Essential Tremor (ET) report anxiety and embarrassment related to their tremor. The emotional burden of functional tremor (FT) is less well understood.

OBJECTIVE

To examine distress tolerance and related psychological symptoms across tremor subtypes.

METHODS

Patients with FT (n = 20), ET (n = 21), and PD (n = 20) completed the Distress Tolerance Scale, Beck's Depression Inventory, and Essential Tremor Embarrassment Assessment. Adverse childhood experiences (ACEs), tremor-related disability, and tremor severity were also assessed.

RESULTS

Patients with FT reported significantly higher depression than both PD and ET groups (overall: F(2,54) = 6.85, p = .002; FT vs. PD: p = .005; FT vs. ET: p = .005), and lower distress tolerance than the PD group (F(2,54) = 3.54, p = .036). No significant differences were found between groups in embarrassment, ACEs, nor disability.

CONCLUSION

This distinct psychological profile in patients with FT highlights the need for integrated biopsychosocial care, and the development of targeted, comprehensive interventions. Tremor is the most common symptom in movement disorder clinics (Sharma and Pandey, 2016 [1]). Essential Tremor (ET) affects ∼5.8 % of people over 65 (Louis and McCreary, 2021 [2]), while Parkinson's Disease (PD) affects ∼1 % of people over 60 (Tysnes and Storstein, 2017 [3]). Functional tremors (FT), the most common functional movement disorder (FMD), comprise 55 % of FMD diagnoses (Bhatia and Schneider, 2007 [4]).