Mental health and quality of life in patients with craniofacial movement disorders: A cross-sectional study

Abstract

BackgroundFacial appearance and expressions influence social interaction. Hemifacial spasm (HFS), blepharospasm (BPS), and blepharospasm-oromandibular dystonia (BOD) are common forms of craniofacial movement disorders. Few studies have focused on the mental burden and quality of life (QoL) in patients with craniofacial movement disorders. Therefore, this study investigated mental health and QoL in these patients.MethodsThis cross-sectional study included 90 patients with craniofacial movement disorders (HFS, BPS, and BOD; 30 patients per group) and 30 healthy individuals without craniofacial movement disorders (control group) recruited from October 2019 to November 2020. All participants underwent QoL and mental health evaluations for depression, anxiety, and stigma using the 36-item Short Form Health Survey (SF-36), Hamilton Anxiety Rating Scale (HAMA), Hamilton Rating Scale for Depression-24 (HAMD-24) and a questionnaire related to stigma.ResultsDepression was diagnosed in 37 (41.11%) patients, whereas 30 patients (33.33%) had anxiety. HAMA scores were significantly higher in the BPS and BOD groups than in the control group. Nineteen patients (21.11%) experienced stigma and SF-36 scores were lower in various dimensions in the movement disorders groups compared to healthy controls. The role-physical and social function scores were significantly lower in the movement disorders groups than in the control group all p < 0.05. The vitality scores of the BPS group and mental health scores of the BPS and BOD groups were significantly lower than those of the control group. Correlation analysis showed that the eight dimensions of SF-36 correlated with education level, disease duration, HAMD score, and HAMA score (all p < 0.05). Regression analysis demonstrated that the HAMD score correlated with general health, vitality, social function, role-emotional, and mental health (all p < 0.05). The HAMA score correlated with body pain after adjusting for education level and disease duration.ConclusionThis study highlights the significant frequency of mental symptoms, including depression, anxiety, and stigma, which lower QoL in patients with craniofacial movement disorders.

Longitudinal predictors of health-related quality of life in isolated dystonia

“…Symptoms of depression are a strong determinator of HR-QoL in dystonia which is in keeping with results of several previous cross-sectional studies in cervical and craniofacial dystonia [ 3 , 9 , 12 ] and other forms of isolated dystonia [ 8 , 30 , 31 ]. In our previous cross-sectional study involving 603 patients from the same cohort including the patients investigated here, and in a study in cervical dystonia, also symptoms of GAD and SAD were associated with all eight subdomains of HR-QoL [ 8 , 9 ].…”

“…However, a recent cross-sectional study in patients with craniofacial dystonia showed similar results using multiple linear regression analysis of depression, anxiety, and SF-36 scores. Anxiety correlated with all eight subdomains of SF36, but after adjusting for disease duration, education level, and depression correlated only with the pain subdomain [ 12 ]. Although depression predicted all subdomains of future HR-QoL in our study, GAD predicted less but relevant subdomains such as general health, emotional well-being and pain and GAD was associated with a significantly lower total QoL as compared to depression (mean HR-QoL: 45.5% ± 17.6 vs. 74.4% ± 16.1).…”

“…Nonmotor symptoms (NMS), i.e. depression, generalized anxiety disorder (GAD), social anxiety disorder (SAD), self-esteem and acceptance of illness often concomitate the motor manifestations in isolated dystonia, occur more frequently than in healthy controls [ 1 – 7 ] and impact on the health-related quality of life (HR-QoL) [ 8 – 12 ]. The previous studies on HR-QoL in dystonia have been cross-sectional [ 8 – 14 ] and do not allow conclusions on predictors of future QoL.…”

Subthalamic nucleus deep brain stimulation in primary Meige syndrome: motor and non‐motor outcomes

“…After neurostimulation, with the marked improvement of blepharospasm, they could independently ambulate without assistance, as reflected by the improvement (73.9%, p < 0.001) of the 'gait' item in the BFMDRS disability scale [25]. Likewise, the quality of life also significantly improved across various components, including physical functioning, role-physical, general health, vitality and social functioning, which is attributed to the dramatic improvement of dystonic symptoms, as previously reported [26,27].…”

“…Recent studies have unveiled non-motor features of dystonia, including sleep disorders and depression [27,33], which may play a vital role in the unknown pathophysiology of the disease. In our study, 23.3% of patients with Meige syndrome had sleep disorders, and 55% of those cases preceded the onset of focal dystonia, such as blepharospasm, by an average duration of 9.8 ± 6.6 years.…”