Case-control study of anxiety symptoms in hemifacial spasm.
In a case-control study, we evaluated symptoms in nine different psychological domains in hemifacial spasm (HFS; using the Symptom Checklist-90R [SCL-90R]) and found the anxiety score to be significantly greater in HFS compared to healthy controls in both the univariate (P = 0.004) and multivariate analysis (adjusted for sex, age, marital status, and educational level; P = 0.002). Similar findings were obtained when comparison was made with an independent group of outpatient controls. Compared to outpatient controls, the HFS patients had a higher mean Hamilton Anxiety Rating Score (HAM-A; 10.0 +/- 8.0 [range, 0 to 28] vs. 5.0 +/- 5.0 [range, 0 to 25]; P = 0.004), and 19.5% had HAM-A score of 18 or above compared to 3.8% in controls (P = 0.02). Among the HFS patients, the mean anxiety score in SCL-90R was significantly higher in those defined with mild to severe anxiety under HAM-A compared to those without anxiety (74.0 +/- 6.0 vs. 48.0 +/- 13.0) (P < 0.0005). There was good correlation of the anxiety score with the HAM-A in HFS patients (r = 0.915; P < 0.0001). HFS patients with anxiety reported significant improvement of their symptoms (mean HAM-A score 19.0 +/- 5.0 vs. 11.0 +/- 6.0; P = 0.001) following appropriate management. As stress and anxiety can aggravate HFS, diagnosis and early management of anxiety symptoms can improve quality of life in these patients.
Tan
Eng-King
EK
Department of Neurology, Singapore General Hospital, Singapore. gnrtek@sgh.com.sg
Fook-Chong
Stephanie
S
Lum
Sau-Ying
SY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D019569:Hemifacial Spasm / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012720:Severity of Illness Index