[Botulinum toxin treatment : therapy success in cases of depression and ongoing pension applications]

A discrepancy is often observed between the presence of botulinum toxin antibodies (Btx-Ab) and successful therapy. We studied whether depression and an ongoing pension application explain this contradiction.

Sixty-five patients treated with Btx were questioned for subjective therapy failure (TF). The extensor digitorum brevis test (EDB test) indicated the presence of Btx-Ab. The Beck Depression Inventory and an exploration investigated for a depressive disturbance as well as an ongoing application for pension. We correlated the EDB test and the TF with a depressive disturbance and the wish for a pension.

Forty-three patients had TF, from which 22 Btx-Ab were positive. A depressive disturbance was found in 25 patients, and an ongoing application for pension in 21. The EDB test and TF did not however correlate TF with a depressive disturbance (P=0.003) and a pension desire (P=0.021). The TF mostly appeared at the beginning of treatment.

A depressive disturbance and an ongoing application for a pension influence the therapeutic success more strongly initially than the development of Btx-Ab.

Besides Btx-Ab a depressive disturbance and an ongoing application for pension influences the therapeutic success.