High psychiatric comorbidity in spasmodic torticollis: a controlled study

Area of Science:

• Neurology
• Psychiatry
• Dermatology

Background:

• Spasmodic torticollis (ST) is associated with high depression, often attributed to body image issues from head disfigurement.
• Previous studies have not adequately controlled for body image dissatisfaction when assessing psychiatric comorbidities in ST.

Purpose of the Study:

• To compare psychiatric comorbidity in patients with spasmodic torticollis (ST) versus alopecia areata (AA).
• To investigate whether psychiatric issues in ST are solely due to disfigurement and body image concerns.

Main Methods:

• Compared 48 ST patients with 48 AA patients matched for age, sex, and body image dissatisfaction.
• Utilized structured psychiatric interviews (SCID-I) for diagnoses.
• Compared results with a matched sample of the German population.

Main Results:

• Patients with ST showed significantly increased odds of psychiatric comorbidity across most DSM-IV categories compared to AA patients.
• Depressive coping strategies and having ST were significant predictors of current psychiatric diagnoses.
• High psychiatric comorbidity in ST is unlikely to be solely a consequence of chronic disease and disfigurement.

Conclusions:

• Spasmodic torticollis is associated with a significantly higher burden of psychiatric comorbidity than other conditions with similar levels of body image dissatisfaction.
• The findings challenge the notion that psychiatric issues in ST are merely a reaction to physical disfigurement.
• Further research is needed to understand the underlying mechanisms driving the high psychiatric comorbidity in ST.