What are the determinants of quality of life in people with cervical dystonia?
Open accessAbstract
BACKGROUND: Little is known about the quality of life in patients with cervical dystonia, although pain and depression are relatively common. OBJECTIVE: To test the hypothesis that an individual's ability to cope with the disease will modify the association of intrinsic, extrinsic, and disease related factors with quality of life. METHODS: Patients with cervical dystonia diagnosed by a movement disorder specialist were recruited from seven European countries. Data on quality of life (SF-36), measures of coping, and intrinsic, extrinsic, and disease related factors were collected by a self completed postal questionnaire. RESULTS: 289 patients (101 men and 188 women), mean age 55 years, completed the questionnaire. Both physical and mental quality of life scores were predicted by self esteem and self deprecation, educational level, employment status, social support, response to botulinum toxin, disease severity, social participation, stigma, acceptance of illness, anxiety, and depression. In multivariable analyses, the strongest predictors were anxiety and depression. Severe depression was associated with a 19.1 point decrement in the physical summary score (95% confidence interval, -31.7 to -6.6; p = 0.003); however, disease duration and severity remained predictors. CONCLUSIONS: Care for patients with cervical dystonia must not only focus on reducing the severity of the dystonia but also on the psychological wellbeing of the patient. Interventions aimed at treating depression or anxiety, especially of a cognitive nature, may have a large impact on improving quality of life.
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Psychiatric difficulties have an impact on both psychological and physical quality of life in cervical dystonia, which in some cases is greater than the cervical dystonia motor severity.
“Psychiatric difficulties have been shown to have an impact on both psychological and physical QoL, which in some cases is greater than the cervical dystonia motor severity [6, 37].”
Psychiatric symptoms, in particular anxiety and depression, have a significant impact on the quality of life of individuals with cervical dystonia, and in some cases a larger impact on their physical quality of life than the severity of the dystonia itself.
“Psychiatric symptoms, in particular anxiety and depression, have been shown to have a significant impact on the quality of life of individuals with cervical dystonia, and in some cases a larger impact on their physical quality of life than the severity of the dystonia itself [6–8].”
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- Authors
- Ben-Shlomo, Y.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2002-05-01
- Volume
- 72
- Issue
- 5
- Pages
- 608-614
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC1737851
- OpenAlex
- W2021575173
- Cited by
- 208
- References
- 46
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 8 · 2023: 10 · 2022: 14 · 2021: 11 · 2020: 23 · 2019: 8 · 2018: 13 · 2017: 12 · 2016: 13 · 2015: 6 · 2014: 7 · 2013: 8 · 2012: 13
- FWCI
- 3.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Medical Research Council
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- cervical dystonia, quality of life, coping, depression, anxiety, disease severity, disease duration, social support, stigma, self-esteem, psychological well-being
- MeSH terms
- Adaptation, Psychological, Anxiety, Cognition, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Quality of Life, Severity of Illness Index, Social Support, Torticollis
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