Spasmodic torticollis - a multicentre study on behavioural aspects IV: psychopathology.
The GSI (General Symptom Index) of the Symptom Checklist 90 R (SCL 90 R) (as a global indicator of the severity of psychiatric symptoms) of 27% of the spasmodic torticollis (ST) sample fell outside the 95% range of the normal control group (two standard deviations). Patients with a higher GSI were younger, more functionally disabled and subject to higher psychosocial stress due to the illness. The highest scores were reached on the subscales of somatization, interpersonal sensitivity and depression. On the depression scale, 23% of the patients' scores were abnormal. This scale correlated significantly with the neurological signs, particularly the TSUI-index and laterocollis. A statistically significant correlation also existed between psychiatric morbidity and a family history of mental disorder. More than 50% of the patients reported that stressful life events had triggered their illness. In order of frequency, a death came first, followed by marital strife, changes in employment and family arguments. The data suggest that psychopathology in ST should generally be considered as a result of a variety of interacting factors, biological, psychological and social.
Abteilung für Psychotherapie und Psychosomatik, Universität Freiburg, Germany.
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Scheidt
Neurologische Klinik und Poliklinik, Universität Freiburg, Germany.
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Heinen
Abteilung für Psychotherapie und Psychosomatik, Universität Freiburg, Germany.
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Nickel
Abteilung für Psychotherapie und Psychosomatik, Universität Freiburg, Germany.
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Rayki
Neurologische Klinik, Rudolf-Virchow-Krankenhaus, Humboldt-Universität Berlin, Germany.
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Wissel
Neurologische Klinik, Rudolf-Virchow-Krankenhaus, Humboldt-Universität Berlin, Germany.
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Poewe
Neurologische Klinik, Universität Düsseldorf, Germany.
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Benecke
Neurologische Klinik, Ludwig-Maximilians-Universität München, Germany.
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Arnold
Neurologische Klinik, Ludwig-Maximilians-Universität München, Germany.
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Oertel
Neurologische Klinik, Medizinische Hochschule Hannover, Germany.
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Dengler
Neurologische Klinik und Poliklinik, Universität Freiburg, Germany.
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Deuschl
Coping; Life events psychopathology; Psychosocial adjustment; Spasmodic torticollis