High psychiatric comorbidity in spasmodic torticollis: a controlled study.
Disturbed body image and negative self-referent cognitions caused by the postural disfigurement of the head are regarded as the main reason for elevated depression scores in spasmodic torticollis (ST), but this factor was never controlled for. We therefore compared 48 patients with ST and 48 patients with alopecia areata (AA) who were matched for age, sex, and body image dissatisfaction. Psychiatric diagnoses were based on a structured psychiatric interview (SCID-I). Results of patients with ST and AA were compared with a matched sample of the representative German population. Odds ratios to develop psychiatric comorbidity for patients with ST compared with patients with AA were significantly increased throughout nearly all assessed DSM-IV categories. Logistic regression analysis showed that (1) depressive coping and (2) belonging to the group of patients with ST correlated with a significantly higher rate of current psychiatric diagnosis. We conclude that high psychiatric comorbidity in ST is unlikely to be a mere consequence of chronic disease and disfigurement.
Gündel
Harald
H
Institut und Poliklinik für Psychosomatische Medizin, Psychotherapie und Medizinische Psychologie, TU München, Klinikum rechts der Isar, Langerstr. 3, D-81675 München, Germany.
Wolf
Anja
A
Xidara
Vassiliki
V
Busch
Raymonde
R
Ladwig
Karl-Heinz
KH
Jacobi
Frank
F
von Rad
Michael
M
Ceballos-Baumann
Andres O
AO
D000506:Alopecia Areata / Q000175:diagnosis / Q000453:epidemiology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001479:Basal Ganglia / Q000503:physiopathology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008959:Models, Neurological; D009434:Neural Pathways / Q000503:physiopathology; D010555:Personality Inventory; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology; D010808:Physical Examination; D011569:Psychiatric Status Rating Scales; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014103:Torticollis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology