A Longitudinal Follow-up Study of Depression, Disability, and Body Concept in Torticollis

Article type: Research Article

Authors: Jahanshahi, M.^; | Marsden, C.D.

Affiliations: MRC Human Movement & Balance Unit & Department of Clinical Neurology, Institute of Neurology, The National Hospital, Queen Square, London, WC1N 3BC, UK

Note: [] Reprint requests: M. Jahanshahi at above address

Abstract: Changes in depression, disability, body concept, and severity of head deviation were examined in a sample of 67 patients with idiopathic torticollis, who were reassessed 2 years after taking part in an initial study (before the use of botulinum toxin injections). Over the follow-up period, torticollis was unchanged in 41·8%, had improved in 26·9% and deteriorated in 31·3% of cases. The overall levels of depression, disability, and body concept across the two occasions did not change. Changes in the clinical severity of torticollis over the follow-up period had a significant effect on psychological adjustment. Those whose torticollis improved were less depressed and disabled and a had a more positive body concept compared to the patients whose torticollis had worsened. Measures of illness severity had stronger associations with measures of psychological adjustment at follow-up than at the time of initial study. Longer duration of torticollis was associated with larger increases in depression and disability during the 2 years of follow-up. The results suggest that the experience of depression, disability, and negative body concept in a proportion of torticollis sufferers is a reaction to the neurological illness. A minority of the patients who remain chronically depressed are primary candidates for therapeutic intervention aiming at improving their adjustment to the illness.

DOI: 10.3233/BEN-1990-3403

Journal: Behavioural Neurology, vol. 3, no. 4, pp. 233-246, 1990