M Smit1, A Kuiper2, V Han3, V C R Jiawan4, G Douma5, B van Harten6, J M T H Oen7, M E Pouwels8, H J G Dieks9, A L Bartels10, M A Tijssen11. 1. University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: m.smit03@umcg.nl. 2. University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: a.kuiper@umcg.nl. 3. Department of Neurology, Safarik University, Hlavna 83/81, 04001 Kosice, Slovakia; Department of Neurology, University Hospital L. Pasteur, Kosice, Slovakia. Electronic address: vladimir.han@gmail.com. 4. University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: v.c.r.jiawan@umcg.nl. 5. Martini Hospital, Department of Neurology, PO Box 30.033, 9700 RM Groningen, The Netherlands. Electronic address: g.douma@mzh.nl. 6. Medical Center Leeuwarden, Department of Neurology, PO Box 888, 8901 BR Leeuwarden, The Netherlands. Electronic address: barbera.van.harten@znb.nl. 7. Antonius Hospital, Department of Neurology, PO Box 20.000, 8600 BA Sneek, The Netherlands. Electronic address: j.oen@antonius-sneek.nl. 8. Scheper Hospital, Department of Neurology, PO Box 30.002, 7800 RA Emmen, The Netherlands. Electronic address: e.pouwels@treant.nl. 9. Röpcke-Zweers Hospital, Department of Neurology, PO Box 1, 7770 AA Hardenberg, The Netherlands. Electronic address: h.dieks@sxb.nl. 10. University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700 RB Groningen, The Netherlands; Ommelander Hospital Group, Department of Neurology, PO Box 30.000, 9930 RA Delfzijl, The Netherlands. Electronic address: a.l.bartels@umcg.nl. 11. University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: m.a.j.de.koning-tijssen@umcg.nl.
Abstract
INTRODUCTION: The aim of this study was to systematically investigate the prevalence of psychiatric disorders and factors influencing health-related quality of life (HR-QoL) in cervical dystonia (CD) patients, in the context of objective dystonia motor severity. METHODS: We studied 50 CD patients and 50 matched healthy controls. Psychiatric assessment included the MINI-PLUS interview and quantitative questionnaires. Dystonia motor severity (based on video evaluation), pain and disability were determined with the TWSTRS rating scale. In addition, severity of tremor and jerks was evaluated with the 7-point CGI-S scale. HR-QoL was determined with the RAND-36 item Health Survey and predictors of HR-QoL were assessed using multiple regression analysis. RESULTS: In CD patients, the MINI-PLUS revealed a significantly higher prevalence of psychiatric disorders (64% vs. 28%, p = 0.001), with substantially more depression (32% vs. 14%) and anxiety disorders (42% vs. 8%). This was confirmed by the quantitative rating scales. Disease characteristics did not differ between patients with and without a psychiatric diagnosis. HR-QoL in dystonia patients was significantly lowered. The most important predictors of HR-QoL appeared severity of depressive symptoms, pain and disability, but not severity of motor symptoms. CONCLUSION: Psychiatric co-morbidity is highly prevalent and is an important predictor of HR-QoL in CD patients, rather than dystonia motor severity. Our findings support the theory of a shared neurobiology for motor and non-motor features and highlight the need for systematic research into psychiatric disorders in dystonia. Adequate treatment of psychiatric symptoms could significantly contribute to better overall quality of life of CD patients.
INTRODUCTION: The aim of this study was to systematically investigate the prevalence of psychiatric disorders and factors influencing health-related quality of life (HR-QoL) in cervical dystonia (CD) patients, in the context of objective dystonia motor severity. METHODS: We studied 50 CDpatients and 50 matched healthy controls. Psychiatric assessment included the MINI-PLUS interview and quantitative questionnaires. Dystonia motor severity (based on video evaluation), pain and disability were determined with the TWSTRS rating scale. In addition, severity of tremor and jerks was evaluated with the 7-point CGI-S scale. HR-QoL was determined with the RAND-36 item Health Survey and predictors of HR-QoL were assessed using multiple regression analysis. RESULTS: In CDpatients, the MINI-PLUS revealed a significantly higher prevalence of psychiatric disorders (64% vs. 28%, p = 0.001), with substantially more depression (32% vs. 14%) and anxiety disorders (42% vs. 8%). This was confirmed by the quantitative rating scales. Disease characteristics did not differ between patients with and without a psychiatric diagnosis. HR-QoL in dystoniapatients was significantly lowered. The most important predictors of HR-QoL appeared severity of depressive symptoms, pain and disability, but not severity of motor symptoms. CONCLUSION:Psychiatric co-morbidity is highly prevalent and is an important predictor of HR-QoL in CDpatients, rather than dystonia motor severity. Our findings support the theory of a shared neurobiology for motor and non-motor features and highlight the need for systematic research into psychiatric disorders in dystonia. Adequate treatment of psychiatric symptoms could significantly contribute to better overall quality of life of CDpatients.
Authors: Bettina Balint; Niccolò E Mencacci; Enza Maria Valente; Antonio Pisani; John Rothwell; Joseph Jankovic; Marie Vidailhet; Kailash P Bhatia Journal: Nat Rev Dis Primers Date: 2018-09-20 Impact factor: 52.329
Authors: Marenka Smit; Arwen S J Kamphuis; Anna L Bartels; Vladimir Han; Roy E Stewart; Inge Zijdewind; Marina A Tijssen Journal: Mov Disord Clin Pract Date: 2016-12-05
Authors: Marenka Smit; Anna L Bartels; Anouk Kuiper; Arwen S J Kamphuis; Vladimir Han; Marina A J Tijssen Journal: Mov Disord Clin Pract Date: 2017-06-15
Authors: Marenka Smit; Alberto Albanese; Monika Benson; Mark J Edwards; Holm Graessner; Michael Hutchinson; Robert Jech; Joachim K Krauss; Francesca Morgante; Belen Pérez Dueñas; Richard B Reilly; Michele Tinazzi; Maria Fiorella Contarino; Marina A J Tijssen Journal: Front Neurol Date: 2021-06-03 Impact factor: 4.003