J Neurol Neurosurg Psychiatry 80:1176-1179 doi:10.1136/jnnp.2008.170191
  • Short report

Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles

  1. R Lencer1,
  2. S Steinlechner1,
  3. J Stahlberg1,
  4. H Rehling1,
  5. M Orth2,
  6. T Baeumer2,
  7. H-J Rumpf1,
  8. C Meyer3,
  9. C Klein4,
  10. A Muenchau2,
  11. J Hagenah4
  1. 1
    Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
  2. 2
    Department of Neurology, University of Hamburg, Hamburg, Germany
  3. 3
    Institute of Epidemiology and Social Medicine, Ernst-Moritz Arndt University, Greifswald, Germany
  4. 4
    Department of Neurology, University of Luebeck, Luebeck, Germany
  1. Correspondence to Dr R Lencer, Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany; rebekka.lencer{at}
  • Received 12 December 2008
  • Revised 2 March 2009
  • Accepted 4 March 2009
  • Published Online First 21 May 2009


Background: Primary focal dystonia (PFD) is characterised by motor symptoms. Frequent co-occurrence of abnormal mental conditions has been mentioned for decades but is less well defined. In this study, prevalence rates of psychiatric disorders, personality disorders and traits in a large cohort of patients with PFD were evaluated.

Methods: Prevalence rates of clinical psychiatric diagnoses in 86 PFD patients were compared with a population based sample (n = 3943) using a multiple regression approach. Furthermore, participants were evaluated for personality traits with the 5 Factor Personality Inventory.

Results: Lifetime prevalence for any psychiatric or personality disorder was 70.9%. More specifically, axis I disorders occurred at a 4.5-fold increased chance. Highest odds ratios were found for social phobia (OR 21.6), agoraphobia (OR 16.7) and panic disorder (OR 11.5). Furthermore, an increased prevalence rate of 32.6% for anxious personality disorders comprising obsessive–compulsive (22.1%) and avoidant personality disorders (16.3%) were found. Except for social phobia, psychiatric disorders manifested prior to the occurrence of dystonia symptoms. In the self-rating of personality traits, PFD patients demonstrated pronounced agreeableness, conscientiousness and reduced openness.

Conclusions: Patients with PFD show distinct neuropsychiatric and personality profiles of the anxiety spectrum. PFD should therefore be viewed as a neuropsychiatric disorder rather than a pure movement disorder.


  • ▸ Supplementary material is published online only at

  • Competing interests None.

  • Ethics approval The study was approved by the local ethics committees.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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