Embarrassment in essential tremor: Prevalence, clinical correlates and therapeutic implications
Open accessAbstract
Background Embarrassment is a commonly described feature of essential tremor (ET) but has not been the focus of clinical research.Objective To estimate the prevalence, identify susceptible patient groups, and quantify the therapeutic correlates of reported embarrassment.Methods A total of 106 ET cases from a population-based sample and 349 ET cases from a clinical sample were asked, "Does your tremor often embarrass you?"Results In the clinical sample, the prevalence of embarrassment was high (58.2%). Even in those ET cases with no head tremor and mild arm tremor, nearly one-half (29/61 [47.5%]) reported embarrassment. While the prevalence of embarrassment was lower in the population-based sample, it was not negligible (18.9%). Embarrassment was associated with younger age of onset (p=0.003) and women were nearly twice as likely as men to report embarrassment (OR=1.85, p=0.01). Independent of tremor severity, embarrassment nearly doubled the odds of using tremor medication (OR=1.86, p=0.01).Conclusions Embarrassment may be a source of disability in ET. Even among clinic patients with mild tremor, nearly one-half reported embarrassment. We identified a number of patient characteristics linked to embarrassment. Embarrassment alone (i.e., independent of tremor severity) was responsible for a doubling of tremor medication usage. The majority of clinical trials do not assess the therapeutic effects of medication on embarrassment. These trials may benefit from scaled assessments of level of embarrassment.
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Research with community- and clinic-based samples of ET sufferers has identified embarrassment as a common consequence of the condition, leading to social anxiety and avoidance.
“Research with community- and clinic-based samples of ET sufferers has identified embarrassment as a common consequence of the condition, leading to social anxiety and avoidance 3-4 .”
From Relations between psychological avoidance, symptom severity and embarrassment in essential tremor (2015) · cites this paper as [3]
The Results (Prevalence of Embarrassment; page unavailable) report embarrassment in 18.9% of the population-based sample and 58.2% of the clinical sample. The Introduction says embarrassment may result in social handicap and possibly social phobia, but the Discussion says its relationship with anxiety needs further study. The paper does not establish that embarrassment leads to social anxiety or avoidance. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEmbarrassment is an important factor in medication uptake in ET, irrespective of symptom severity.
“On the other hand, embarrassment was an important factor in medication uptake, irrespective of symptom severity 3 .”
From Relations between psychological avoidance, symptom severity and embarrassment in essential tremor (2015) · cites this paper as [3]
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- Authors
- Louis, E. D., & Rios, E.
- Affiliations
- Columbia University (US)
- Corresponding author
- Louis, Elan D.
- ORCID
- Louis, Elan D.
- Venue
- Parkinsonism & Related Disorders
- Publisher
- Elsevier BV
- Published
- 2009-08
- Volume
- 15
- Issue
- 7
- Pages
- 535-538
- ISSN
- 1353-8020 (ISSN-L)
- PMC
- PMC2712578
- OpenAlex
- W2017440739
- Cited by
- 47
- References
- 9
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 1 · 2019: 6 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 4
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Parkinsonism & Related Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institute of Neurological Disorders and Stroke (R01 NS 39422, R01NS039422)
- National Center for Research Resources (RR 00645, M01RR000645)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- essential tremor, embarrassment
- MeSH terms
- Affective Symptoms, Aged, Aged, 80 and over, Disability Evaluation, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Severity of Illness Index, Prevalence, Essential Tremor
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