title: Cervical dystonia and quality of life.
abstract: Cervical dystonia is focal dystonia characterized by involuntary movement of the neck muscle, which leads to abnormal head posture. It can be accompanied with pain and tremor. In this study, we evaluated the presence of depression and anxiety in patients with cervical dystonia and the influence of dystonia symptoms on the quality of life. Psychiatric symptoms were evaluated by use of the Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was used to evaluate the cervical dystonia symptoms. Quality of life was assessed by the craniocervical dystonia questionnaire (CDQ-24) and short form 36 health survey (SF-36). Nineteen patients were analyzed. Most of the patients had mild cervical dystonia (mean TWSTRS 23.89). Depression was present in 42.1 % and anxiety in 57.9 % of the patients. Disability due to cervical dystonia correlated with the occurrence of depression (ρ = 0.534) and anxiety (r = 0.652). Disability was found to significantly influence the stigma, emotional state, pain, daily activity, social life, physical function, and physical and mental disability. Pain influenced some aspects of body pain, physical function, and physical and mental disability. Being associated with disability and pain, cervical dystonia decreases the quality of life in many aspects. Disability also influenced depression and anxiety, which were present in half of study patients. In addition to follow up for cervical dystonia symptoms, patients with cervical dystonia should also be assessed for psychiatric symptoms on routine clinical check-ups. In addition to botulinum toxin, psychopharmaceuticals should be considered as a treatment option in these patients.
authors.affiliation: Clinical Department of Neurology, Osijek University Hospital Center, Josipa Huttlera 4, 31000, Osijek, Croatia. svetlana.tomic@vip.hr.|School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia. svetlana.tomic@vip.hr.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Tomic
authors.affiliation: School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Petkovic
authors.affiliation: Clinical Department of Neurology, Osijek University Hospital Center, Josipa Huttlera 4, 31000, Osijek, Croatia.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Pucic
authors.affiliation: School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia.|School of Engineering, University of Applied Sciences and Arts Northwestern Switzerland, Windisch, Switzerland.
authors.forename: Bojan
authors.initials: B
authors.lastname: Resan
authors.affiliation: Clinical Department of Neurology, Osijek University Hospital Center, Josipa Huttlera 4, 31000, Osijek, Croatia.|School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia.
authors.forename: Stjepan
authors.initials: S
authors.lastname: Juric
authors.affiliation: Clinical Department of Radiology, Osijek University Hospital Center, Osijek, Croatia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rotim
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014103:Torticollis / Q000523:psychology*
keywords: Anxiety; Cervical dystonia; Depression; Quality of life