DEPRESSION AND ANXIETY IN CERVICAL DYSTONIA PATIENTS VERSUS SPINE PAIN CONTROLS

Drake D. Duane, M.D., Michael Berman, B.S.

Arizona Dystonia Institute/Arizona State University

Scottsdale/Tempe, Arizona

To clarify the role of psychiatric factors in focal dystonia, 201 cervical dystonia (CD) patients (49M/152F; Mn age 55y; SD 12.6) and 135 spine pain patieits (48M/87F; Mn age 52y; SD 15) were personally questioned about psychiatric history. 191 CD and 95 control patients completed Minnesota Multiphasic Personality Inventory (MMPIS) and/or Beck Depression, Spielberger Anxiety Scales. History of antecedent psychiatric diagnosis/therapy occurred in 20% CD and 18% controls. For both groups, anxiety, depression and for alcoholism were the predominant diagnoses. 50% of CD patients recalled the year preonset as one of unusual psychosocial stress. Excluding patients in whom causal psychiatric diagnosis was sought for CD, 13% of CD and 3% of controls had psychiatric diagnosis/therapy postonset (p <.001).

180 CD (46M/134F, Mn age 55, Mn duration 8.8 years) and 63 control patients (21M/42F, Mn age 49 years, Mn duration 4.7y) completed MMPIS. 18% CD and 13% controls had depression (D) score > T70 (p <.05). 33% CD and 37% controls had Purdue Anxiety score > T70. Both D and Purdue scores were elevated in 14% CD and 13% controls.

Anxiety is common in patients with either CD or spine pain. The increment in depression differs with the findings of Jahanshahi and Marsden, Psychological Medicine, 1988, 18:925-933. As in Lauterbach, et al., Neurology 1991, 41 (Supplement 1): 293, severity of dystonia did not correlate with either affective or anxiety disorder, nor did symptom duration. Patients with a psychiatric history were more apt to have elevated scores. The postonset increment in psychiatric diagnosis may reflect a more devastating effect of dystonia upon psychological stability.

Poster presentation, June 25, 1.9.92, Second International Congress of Movement Disorders, Munich, Germany, June, 1992.

Duane, D.,D., Berman, M.B. Depression and anxiety in cervical dystonia patients versus spine pain controls. Movement Disorders, VII, (Supplement I). 124, 1992.

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