Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles
- R Lencer1,
- S Steinlechner1,
- J Stahlberg1,
- H Rehling1,
- M Orth2,
- T Baeumer2,
- H-J Rumpf1,
- C Meyer3,
- C Klein4,
- A Muenchau2,
- J Hagenah4
- 1Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
- 2Department of Neurology, University of Hamburg, Hamburg, Germany
- 3Institute of Epidemiology and Social Medicine, Ernst-Moritz Arndt University, Greifswald, Germany
- 4Department of Neurology, University of Luebeck, Luebeck, Germany
- Correspondence to Dr R Lencer, Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany;
- 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 http://jnnp.bmj.com/content/vol80/issue10
Competing interests None.
Ethics approval The study was approved by the local ethics committees.
Provenance and Peer review Not commissioned; externally peer reviewed.