Body Concept, Disability, and Depression in Patients with Spasmodic Torticollis

Jahanshahi, M.; Marsden, C. D.

doi:10.1155/1990/764203

Cited by 70 publications

(62 citation statements)

References 7 publications

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“…In CD, similar results have been reported by Jahanshahi, et al who suggested that depression may constitute a reaction to the postural abnormality of the head [4][5][6][7]. However, in the present study neck pain represented the main determinant of depression in CD.…”

Section: Discussionsupporting

confidence: 89%

The impact of blepharospasm and cervical dystonia on health-related quality of life and depression

Müller¹,

Kemmler

Wissel³

et al. 2002

Journal of Neurology

177

164

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The aim of the study was to evaluate and compare health-related quality of life (HR-QoL) and depression in essential blepharospasm (BSP) and idiopathic cervical dystonia (CD), to identify the clinical and demographic factors associated with poor HR-QoL in both disorders and to analyse the effect of Botulinum Toxin A (BtxA) therapy. Two hundred-twenty consecutive patients with BSP (N = 89, 62 % women, mean age 64 years, mean disease duration 7 years) and CD (N = 131, 64 % women, mean age 53 years, mean disease duration 8 years) recruited from routine referrals to eight Austrian dystonia clinics were included. HR-QoL was measured by the Short Form 36 (SF-36) and depression by the Beck Depression Inventory (BDI). At baseline, patients with CD and BSP scored significantly worse in all eight SF-36 domains compared with an age-matched community sample. In addition, 47 % of patients with CD and 37 % of those with BSP were depressed. Women with BSP scored significantly lower in all SF-36 domains and were more depressed than male patients. In contrast, there was no significant effect of gender on HR-QoL and depression in CD. Neck pain had a significant impact on all SF-36 domains and represented the main determinant of depression in CD. Although BtxA therapy resulted in a significant improvement of clinical symptoms in BSP and CD, HR-QoL did not improve in BSP and only two of the eight SF-36 domains improved significantly in patients with CD. The present study for the first time demonstrated that BSP has a substantial impact on health status emphasizing the need for psychological support with interventions aimed at treating depression in these patients. Our results provide further evidence for the profound impact of CD on HR-QoL and indicate the importance of an adequate management of neck pain in addition to reducing the severity of dystonia in CD. The mismatch between objective BtxA derived improvement of dystonia and lack of change of HR-QoL as determined by the SF-36 illustrates the need for optimized disease specific quality of life rating scales in patients with craniocervical dystonia.

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Section: Discussionsupporting

confidence: 89%

The impact of blepharospasm and cervical dystonia on health-related quality of life and depression

Müller¹,

Kemmler

Wissel³

et al. 2002

Journal of Neurology

177

164

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“…Moderate to severe depression has been reported in up to one half of patients with CD [17][18][19]26]. Depressed mood requiring treatment was a prominent feature in the patients in our study.…”

Section: Discussionsupporting

confidence: 50%

Cervical dystonia following peripheral trauma

O’Riordan

Hutchinson

2004

J Neurol

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Post-traumatic cervical dystonia as a diagnostic entity remains a subject of debate. Patients with cervical dystonia (CD) were asked to identify any significant illness prior to the onset of their CD. Sixteen patients of 95 respondents reported a history of injury in the four-week period prior to onset of their dystonia. A retrospective study of the clinical characteristics of the 16 patients with early post-traumatic CD (CD-PT) in comparison with the 52 patients reporting no antecedent trauma (CD-NT) was performed. In this comparison the CD-PT group had a significantly increased frequency of laterocollis, significantly more reported pain and more reported depression. Non-significant trends were noted for less responsiveness to botulinum toxin and less use of gestes antagonistes in the CD-PT group. There were no group differences in the presence of a family history of dystonia. Eleven of the CD-PT group had been or were currently involved in litigation. A sub-group of seven CD-PT patients had laterocollis, six of whom conformed to a clinical pattern of persistent non-spasmodic laterocollis with marked pain; all seven had been involved in litigation. This form of CD-PT is a distinct clinical entity and has an onset within hours or a few days of the trauma. In contrast, no significant differences were noted between patients with CD-NT and the eight patients with later onset of CD between 4 weeks and one year after peripheral trauma.

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“…Functional disability questionnaire (FDQ) [18] This scale developed by Jahanshahi & Marsden was shown to have good internal consistency, reliability and validity [18]. It measures the impact of dystonia on activities of daily living.…”

Section: Beck Depression Inventory (Bdi) [20]mentioning

confidence: 99%

“…To date, a detailed investigation of depression has only been completed in cervical dystonia [4,18]. There is very little information about the nature and features of depression in other forms of focal dystonia or in segmental and generalized dystonia.…”

Section: Introductionmentioning

confidence: 99%

Depression in focal, segmental and generalized dystonia

Lewis

Butler²,

Jahanshahi

2008

J Neurol

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Dystonia causes body disfigurement in the majority of those affected. Our aim was to test the hypothesis that low self-esteem resulting from the sense of disfigurement is an important component of self-reported depression in focal, segmental and generalized dystonia. Questionnaires to assess self-reported depression, self-esteem, body concept, disfigurement, disability and quality of life were completed by 329 community based dystonia patients. Moderate to severe depression was reported by 30 %. Self-reported depression had a strong somatic component, but patients also showed a specific concern with self-image. Extent of dystonia, body parts affected and marital status influenced self-reported depression in dystonia. Self esteem, body concept, disfigurement and quality of life emerged as factors which accounted for the variance of self-reported depression in dystonia. These results suggest that in dystonia, disfigurement, negative body concept, low self-esteem, and the impact of the disease on quality of life make important contributions to depression. However, longitudinal followup is required to firmly establish the direction of causality between depression and these psychosocial variables in dystonia.

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Body Concept, Disability, and Depression in Patients with Spasmodic Torticollis

Cited by 70 publications

References 7 publications

The impact of blepharospasm and cervical dystonia on health-related quality of life and depression

The impact of blepharospasm and cervical dystonia on health-related quality of life and depression

Cervical dystonia following peripheral trauma

Depression in focal, segmental and generalized dystonia

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