title: Depression in focal, segmental and generalized dystonia.
abstract: Dystonia causes body disfigurement in the majority of those affected. Our aim was to test the hypothesis that low self-esteem resulting from the sense of disfigurement is an important component of self-reported depression in focal, segmental and generalized dystonia. Questionnaires to assess self-reported depression, self-esteem, body concept, disfigurement, disability and quality of life were completed by 329 community based dystonia patients. Moderate to severe depression was reported by 30 %. Self-reported depression had a strong somatic component, but patients also showed a specific concern with self-image. Extent of dystonia, body parts affected and marital status influenced self-reported depression in dystonia. Self esteem, body concept, disfigurement and quality of life emerged as factors which accounted for the variance of self-reported depression in dystonia. These results suggest that in dystonia, disfigurement, negative body concept, low self-esteem, and the impact of the disease on quality of life make important contributions to depression. However, longitudinal followup is required to firmly establish the direction of causality between depression and these psychosocial variables in dystonia.
authors.affiliation: Cognitive-Motor Neuroscience Group, Sobell Department of Motor Neuroscience & Movement Disorders, Institute of Neurology & The National Hospital for Neurology & Neurosurgery, Queen Square, London WC1N 3BG, UK.
authors.forename: L
authors.initials: L
authors.lastname: Lewis
authors.forename: A
authors.initials: A
authors.lastname: Butler
authors.forename: M
authors.initials: M
authors.lastname: Jahanshahi
mesh_terms: D017668:Age of Onset; D001828:Body Image; D003863:Depression; D006233:Persons with Disabilities / Q000523:psychology; D004421:Dystonia / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires