Funding agencies: This study was supported by a research grant from the Portuguese Neurological Society, sponsored by Novartis.
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Research Article
Article first published online: 9 AUG 2011
DOI: 10.1002/mds.23906
Copyright © 2011 Movement Disorder Society
Additional Information
How to Cite
Barahona-Corrêa, B., Bugalho, P., Guimarães, J. and Xavier, M. (2011), Obsessive-compulsive symptoms in primary focal dystonia: A controlled study. Mov. Disord., 26: 2274–2278. doi: 10.1002/mds.23906
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Relevant conflicts of interest/financial disclosures: Nothing to report.
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Full financial disclosures and author roles may be found in the online version of this article.
Publication History
- Issue published online: 21 OCT 2011
- Article first published online: 9 AUG 2011
- Manuscript Accepted: 15 JUL 2011
- Manuscript Revised: 6 JUL 2011
- Manuscript Received: 21 FEB 2011
- Abstract
- Article
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- Cited By
Keywords:
- obsessive-compulsive disorder;
- spasmodic torticollis;
- blepharospasm;
- writer's cramp;
- neuropsychiatry
Abstract
Primary focal dystonia is an idiopathic neurological disorder causing involuntary muscle contraction. Its pathophysiology probably involves the basal ganglia and cortical-basal pathways. Primary dystonia appears to be associated with significant obsessive-compulsive symptoms, but evidence remains scarce and contradictory. We addressed the following research questions: (1) Do primary dystonia patients have high obsessive-compulsive symptom scores? (2) Are these symptoms more severe in dystonia than in controls with equivalent peripheral neurological disorders? and (3) Is psychopathology different in botulinum toxin-treated and -untreated dystonia patients? This work was a cross-sectional, descriptive, controlled study comprising 45 consecutive patients with primary focal dystonia (i.e., blepharospasm, spasmodic torticollis, or writer's cramp) 46 consecutive patients with hemifacial spasm, cervical spondylarthropathy, or carpal tunnel syndrome, and 30 healthy volunteers. Assessment included the DSM-IV based psychiatric interview, Symptom Checklist 90R, Yale-Brown Obsessive-Compulsive Scale and Checklist, and the Unified Dystonia Rating Scale. Dystonia patients had higher Yale-Brown Obsessive-Compulsive Symptom scores than both control groups. Dystonia patients with obsessive-compulsive symptom scores above cut-off for clinical significance predominantly developed hygiene-related symptoms. Major depression and generalized anxiety disorder were the most frequent psychiatric diagnoses in primary focal dystonia. Obsessive-compulsive disorder frequency was 6.7%. Primary focal dystonia patients have higher obsessive-compulsive symptom scores than individuals with similar functional disabilities resulting from other neurological disorders, suggesting that obsessive-compulsive symptoms in dystonia are not reactive to chronic disability. Dystonic muscle contractions and obsessive-compulsive symptoms may share a common neurobiological basis related to cortical-basal dysfunction. Psychopathology, especially obsessive-compulsive symptoms, should be actively explored and treated in primary focal dystonia. © 2011 Movement Disorder Society