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Primary Focal Dystonia: Evidence for Distinct Neuropsychiatric and Personality Profiles
  1. Rebekka Lencer (rebekka.lencer{at}psychiatrie.uk-sh.de)
  1. University of Luebeck, Germany
    1. Susanne Steinlechner (susanne.steinlechner{at}psychiatrie.uk-sh.de)
    1. University of Luebeck, Germany
      1. Jessica Stahlberg (jessicastahlberg{at}aol.com)
      1. University of Luebeck, Germany
        1. Hilka Rehling (hilkarehling{at}gmx.de)
        1. University of Luebeck, Germany
          1. Michael Orth (michael.orth{at}uni-ulm.de)
          1. University of Ulm, Germany
            1. Tobias Baeumer (baeumer{at}uke.uni-hamburg.de)
            1. University of Hamburg, Germany
              1. Hans-Juergen Rumpf (hans-juergen.rumpf{at}psychiatrie.uk-sh.de)
              1. University of Luebeck, Germany
                1. Christian Meyer (chmeyer{at}uni-greifswald.de)
                1. University of Greifswald, Germany
                  1. Christine Klein (christine.klein{at}neuro.uni-luebeck.de)
                  1. University of Luebeck, Germany
                    1. Alexander Muenchau (muenchau{at}uke.uni-hamburg.de)
                    1. University of Hamburg, Germany
                      1. Johann Hagenah (johann.hagenah{at}neuro.uni-luebeck.de)
                      1. University of Luebeck, Germany

                        Abstract

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

                        Methods: Prevalence rates of clinical psychiatric diagnoses in 86 PFD patients were compared to a population-based sample (N=3943) using a multiple regression approach. Furthermore, participants were evaluated for personality disorders with the Five 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). We further found an increased prevalence rate of 32.6% for anxious personality disorders comprising obsessive-compulsive (22.1%) and avoidant personality disorders (16.3%). 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.

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