Gender and Age Determinants of Psychogenic Movement Disorders: A Clinical Profile of 73 Patients

Abstract

Background: Psychogenic movement disorders (PMD) is a group of disorders that cannot be attributed to any structural or biochemical abnormality, but has an underlying psychiatric illness. The profile of PMD varies according to country and socioeconomic factors. Methods: The present study reports the clinical profile of patients with PMD from India. Seventy-three patients with documented or clinically established PMD were seen over a period of 14 years with detailed neurological and psychiatric examinations. Results: The mean age at presentation was 29.1 ± 15.1 years (women, 51%). Approximately 30% were ≤18 years of age (boys, 63.6%). The onset of symptoms was abrupt in 61.6% and the initial body part most often affected was right upper limb (adults, 29.4%; children, 31.8%). Tremor was observed in 31.4% of adults and 9% of children, whereas myoclonus was more common in children (36.4%). Tremors were more often seen in women (42.3%) than in men (20%), whereas myoclonus was almost equally prevalent in girls (37.5%) and boys (35.7%). Depression was the most common psychiatric comorbidity (men, 16%; women, 15.4%). About 42.5% required hospital admission and 57.5% had significant reduction or complete cessation of PMD after counseling, antidepressants, and/ or placebo. Conclusions: PMD was equally prevalent among women and men. Tremor was most often observed in adults, whereas myoclonus was most often observed in children. Electrophysiology and placebo were useful supplementary tools for diagnosing PMD.RÉSUMÉ: Déterminants des sujets présentant des troubles psychogènes du mouvement selon le sexe et l'âge: profil clinique de 73 patients. Contexte: Les troubles psychogènes du mouvement (TPM) constituent un groupe de problèmes de santé qui ne peuvent être attribués à aucune anomalie structurale ou biochimique et qui sont dus à une maladie psychiatrique sous-jacente. Le profil des TPM varie selon le pays et les facteurs socio-économiques des patients. Méthode: Nous rapportons le profil de patients présentant des TPM en Inde. Soixante-treize patients présentant des TPM documentés ou établis cliniquement ont subi des examens neurologiques et psychiatriques détaillés au cours d'une période de 14 ans. Résultats: L'âge moyen des patients au moment de la consultation initiale était de 29,1 ± 15.1 ans et 51% étaient des femmes. À peu près 30% étaient âgés de 18 ans ou moins et parmi eux, 63,6% étaient des garçons. Le début des symptômes avait été soudain chez 61,6% et la partie du corps initialement touchée était le plus souvent le membre supérieur droit (29,4% chez les adultes, 31,8% chez les enfants). Chez les adultes, 31,4% avaient du tremblement ainsi que 9% des enfants. La myoclonie était plus fréquente chez les enfants (36,4%). Les tremblements étaient plus fréquemment observés chez les femmes (42,3%) que chez les hommes (20%). La myoclonie était presqu'aussi fréquente chez les filles (37,5%) que chez les garçons (35,7%). La dépression était la comorbidité psychiatrique la plus fréquente tant chez les hommes (16%...

Psychogenic Movement Disorders in Adults and Children: A Clinical and Video Profile of 58 Indian Patients

“…Even in studies that involved pediatric patients with PMD, there were 3 to 4 times more girls than boys . The relatively less representation of both adult women and young girls in our study may stem from the prevalent sociocultural factors in our country, which also was reflected in another Indian study in which no significant difference was observed in the prevalence of PMD among men and women …”

“…Schwingenschuh and colleagues had different observations in 15 children with PMD: those authors reported that dystonia (47%) was the most common PMD, followed by tremor (40%), and gait disorders (13%) . In 1 Indian study reported by Kamble and colleagues, myoclonus was the most common PMD phenotype, and tremor was observed in only 9% of children . Dystonia was the second most common PMD (n = 4; 16%) in our pediatric population along with gait abnormality (n = 4; 16%) and was third most common PMD in our adult population (n = 3; 9.09%).…”

Clinical Characteristics of Functional Movement Disorders: A Clinic-based Study

“…This further highlights symptom duration as an important prognostic factor in functional movement disorders. Our results therefore support previous observations that prolonged symptom duration is associated with poor prognosis 5,7,15. We also confirmed previous reports of tremor as the most frequent movement occurring in functional movement disorders 8…”

“…To date, several clinic-based studies on the epidemiology of functional movement disorders have been reported 5,8,12–14. These studies have been mostly conducted in the United States and Europe, and knowledge of the epidemiology and clinical characteristics of this patient population in other regions of the world such as Eastern Asia is lacking.…”

Psychogenic dystonia of the hand: A clinical case

“…От-метим, что в неврологическом статусе при наличии демон-стрируемых вынужденных «непроизвольных» поз кисти не отмечается какого-либо (по спастическому или пластиче-скому типу) повышения мышечного тонуса в кисти и руке; нет асимметрии сухожильных рефлексов; отсутствует атро-фия мышц кисти и предплечья; нет клинических признаков болевого синдрома или указаний на него в анамнезе. При ЭНМГ периферических нервов правой руки также не выяв-лено отклонений (хотя проведение ЭНМГ при психогенной дистонии нецелесообразно) [34].…”