Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles.
BACKGROUND
Primary focal dystonia (PFD) is characterised by motor symptoms. Frequent co-occurrence of abnormal mental conditions has been mentioned for decades but is less well defined. In this study, prevalence rates of psychiatric disorders, personality disorders and traits in a large cohort of patients with PFD were evaluated.


METHODS
Prevalence rates of clinical psychiatric diagnoses in 86 PFD patients were compared with a population based sample (n = 3943) using a multiple regression approach. Furthermore, participants were evaluated for personality traits with the 5 Factor Personality Inventory.


RESULTS
Lifetime prevalence for any psychiatric or personality disorder was 70.9%. More specifically, axis I disorders occurred at a 4.5-fold increased chance. Highest odds ratios were found for social phobia (OR 21.6), agoraphobia (OR 16.7) and panic disorder (OR 11.5). Furthermore, an increased prevalence rate of 32.6% for anxious personality disorders comprising obsessive-compulsive (22.1%) and avoidant personality disorders (16.3%) were found. Except for social phobia, psychiatric disorders manifested prior to the occurrence of dystonia symptoms. In the self-rating of personality traits, PFD patients demonstrated pronounced agreeableness, conscientiousness and reduced openness.


CONCLUSIONS
Patients with PFD show distinct neuropsychiatric and personality profiles of the anxiety spectrum. PFD should therefore be viewed as a neuropsychiatric disorder rather than a pure movement disorder.
Lencer
R
R
Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany. rebekka.lencer@psychiatrie.uk-sh.de
Steinlechner
S
S
Stahlberg
J
J
Rehling
H
H
Orth
M
M
Baeumer
T
T
Rumpf
H-J
HJ
Meyer
C
C
Klein
C
C
Muenchau
A
A
Hagenah
J
J
D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology*; D017668:Age of Onset; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D020821:Dystonic Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010551:Personality; D015995:Prevalence; D012307:Risk Factors