PSYCHIATRIC COMORBIDITY IN PATIENTS WITH SPASMODIC TORTICOLLIS

Several studies have reported raised levels of psychopathology based o n self-rating scales in patients with spasmodic torticollis. Recent pu blications have also proposed that psychopathology, especially symptom s of depression, might be a reaction to dystonia or constitute a nonsp ecific reaction pattern. To determine the actual frequency of psychiat ric disorders, we evaluated 44 patients with spasmodic torticollis (20 female, 24 male; mean age 43.6 years, so 10.4) using the standard ins trument for psychiatric diagnosis in the DSM-III-R (Structured Clinica l Interview Schedule, SCID). The SCID permits retrospective diagnosis for most of the major psychiatric disorders, including the time before onset of dystonia. SCID criteria for at least one psychiatric disorde r were fulfilled in 65.9% of patients, including both lifetime and cur rent diagnosis. The most frequent diagnostic categories were panic dis order with or without agoraphobia (29.5%), major depressive disorder ( 25%), substance abuse (13.6%), and obsessive compulsive disorders (6.8 %) were diagnosed less frequently. The patient-recalled onset of psych iatric symptoms preceded onset of torticollis symptoms in 43.2% of tho se investigated. (C) 1998 Elsevier Science Inc.