Psychiatric Comorbidities in Dystonia: Emerging Concepts
Identifieur interne : 000343 ( Pmc/Curation ); précédent : 000342; suivant : 000344Psychiatric Comorbidities in Dystonia: Emerging Concepts
Auteurs : Mateusz Zurowski [Canada] ; William M. Mcdonald [États-Unis] ; Susan Fox [Canada] ; Laura Marsh [États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2013.
Abstract
Psychiatric disorders are highly prevalent in patients with dystonia and have a profound effect on quality of life. Patients with dystonia frequently meet criteria for anxiety disorders, especially social phobia, and major depressive disorder. Deficits in emotional processing have also been demonstrated in some dystonia populations. Onset of psychiatric disturbances in patients with dystonia often precedes onset of motor symptoms suggesting that the pathophysiology of dystonia itself contributes to the genesis of psychiatric disturbances. This article examines the hypothesis that mood and anxiety disorders are intrinsic to the neurobiology of dystonia, citing the available literature, which is derived mostly from research on focal isolated dystonias. Limitations of studies are identified and the role of emotional reactivity, especially in the context of pain secondary to dystonia, is recognized. Available evidence underscores the need to develop dystonia assessment tools that incorporate psychiatric measures. Such tools would allow for a better understanding of the full spectrum of dystonia presentations and facilitate research on the treatment of dystonia as well as the treatment of psychiatric illnesses in the context of dystonia.
Url:
DOI: 10.1002/mds.25501
PubMed: 23893448
PubMed Central: 3842100
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<front><div type="abstract" xml:lang="en"><p id="P1">Psychiatric disorders are highly prevalent in patients with dystonia and have a profound effect on quality of life. Patients with dystonia frequently meet criteria for anxiety disorders, especially social phobia, and major depressive disorder. Deficits in emotional processing have also been demonstrated in some dystonia populations. Onset of psychiatric disturbances in patients with dystonia often precedes onset of motor symptoms suggesting that the pathophysiology of dystonia itself contributes to the genesis of psychiatric disturbances. This article examines the hypothesis that mood and anxiety disorders are intrinsic to the neurobiology of dystonia, citing the available literature, which is derived mostly from research on focal isolated dystonias. Limitations of studies are identified and the role of emotional reactivity, especially in the context of pain secondary to dystonia, is recognized. Available evidence underscores the need to develop dystonia assessment tools that incorporate psychiatric measures. Such tools would allow for a better understanding of the full spectrum of dystonia presentations and facilitate research on the treatment of dystonia as well as the treatment of psychiatric illnesses in the context of dystonia.</p>
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Department of Psychiatry, University of Toronto, University Health Network, Toronto, Canada</aff>
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Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA</aff>
<aff id="A3"><label>3</label>
Division of Neurology, University of Toronto, University Health Network, Toronto, Canada</aff>
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Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center and Departments of Psychiatry and Neurology, Baylor College of Medicine, Houston, Texas, USA</aff>
<author-notes><corresp id="FN1">Address correspondence to: Mateusz Zurowski, Department of Psychiatry, Toronto Western Hospital, University Health Network, 7 Main, 399 Bathurst St., Toronto, Ontario, Canada, M5T 2S8. <email>mateusz.zurowski@uhn.ca</email>
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<pub-date pub-type="nihms-submitted"><day>9</day>
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<pub-date pub-type="pmc-release"><day>15</day>
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<year>2014</year>
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<volume>28</volume>
<issue>7</issue>
<elocation-id>10.1002/mds.25501</elocation-id>
<abstract><p id="P1">Psychiatric disorders are highly prevalent in patients with dystonia and have a profound effect on quality of life. Patients with dystonia frequently meet criteria for anxiety disorders, especially social phobia, and major depressive disorder. Deficits in emotional processing have also been demonstrated in some dystonia populations. Onset of psychiatric disturbances in patients with dystonia often precedes onset of motor symptoms suggesting that the pathophysiology of dystonia itself contributes to the genesis of psychiatric disturbances. This article examines the hypothesis that mood and anxiety disorders are intrinsic to the neurobiology of dystonia, citing the available literature, which is derived mostly from research on focal isolated dystonias. Limitations of studies are identified and the role of emotional reactivity, especially in the context of pain secondary to dystonia, is recognized. Available evidence underscores the need to develop dystonia assessment tools that incorporate psychiatric measures. Such tools would allow for a better understanding of the full spectrum of dystonia presentations and facilitate research on the treatment of dystonia as well as the treatment of psychiatric illnesses in the context of dystonia.</p>
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