Differential DSM-III Psychiatric Disorder Prevalence Profiles in Dystonia and Parkinson’s Disease

Abstract

The authors investigated the prevalence of DIS-ascertained DSM-III psychiatric disorders occurring in 28 patients with dystonia and 28 patients with Parkinson's Disease (PD). In patients with dystonia, lifetime prevalences of major depression (25.0%), bipolar disorder (7.1%), atypical bipolar disorder (7.1%), social phobia (17.9%), and generalized anxiety disorder (25.0%) were significantly more common than in epidemiologic catchment area (ECA) study population controls (p < 0.005). Social phobia and generalized anxiety disorder preceded dystonia (primary), while bipolar disorder developed after dystonia onset (secondary). In PD patients, the lifetime prevalence of simple phobia (35.7%, p < 0.0001) and atypical depression (21.4%) were significantly more common. Parkinson's Disease was associated with primary simple phobia and secondary atypical depression. These findings are considered in light of previous results and in terms of the differences in pallidothalamic physiologies in dystonia and PD. These data suggest distinctive profiles of psychiatric disorders in dystonia and PD.

Nonmotor manifestations of dystonia: A systematic review

“…The prevalence of depression and anxiety in patients with dystonia varies based on the study and on sample size, but cohorts analyzed in this article indicate that 12%–71% of patients with focal or generalized dystonia suffer from depression and anxiety over the course of a lifetime, with most studies falling in the range of about 25%–50%. This percentage is similar to that for Parkinson's disease, which also disturbs frontal‐subcortical circuits 6, 7. It is increased compared with those who are healthy8–11 and those with other medical conditions 12–14…”

“…Given the typical sensitivity of myoclonus to alcohol, the alcohol dependence seen in certain patients may be the result of alcohol's symptomatic effects rather than a manifestation of the gene itself 38. Aside from the connection to DYT11 , alcohol abuse was found to be significantly higher than healthy controls in a small cohort of patients with primary generalized dystonia and spasmodic torticollis 6…”

Clinical feature and DYT1 mutation screening in primary dystonia patients from South‐West China

“…Further, the mean age of our patients was 43, and they may have more VT. The occurrence of depression and anxiety was a bit lower than that in other previous reports (25%) [20,29,30]. This result can be associated with the reluctance of Chinese people to talk about their emotions.…”

Neuropsychiatric Symptoms in Parkinson’s Disease

“…Approximately 30-40% of patients with PD have significant depressive symptoms, with lower prevalence rates in population-based studies [3][4][5]. Anxiety affects up to 40% of patients with PD [6][7][8][9][10][11]. Symptoms of both depression and anxiety can be off-period related phenomena, which are usually, but not always, seen in parallel to motor fluctuations, and can then be particularly severe but respond to antiparkinsonian medication [12][13][14][15].Both depression and anxiety can predate motor symptoms by several years and belong to the non-motor features that may herald the development of PD [16].…”