Article Text

Download PDFPDF
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}


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.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • ▸ 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.

Linked Articles