Spasmodic torticollis: A psychogenic condition?

Abstract

Thirty-two patients, suffering from idiopathic spasmodic torticollis (ST) since 9 ± 8 years, participated. In addition to a rating of the neurological symptoms (posture, reduced motility, rigidity, tremor, spasmodic movements, neck pain) and a psychiatric exploration, as well as two questionnaires on personality variables (Minnesota Multiphasic Personality Inventory [MMPI]) and coping styles (Millon Behavioral Health Inventory) were investigated. A control group of patients with Parkinson's disease also filled out both questionnaires. Three patients had another neurological and two another psychiatric disease. MMPI scores, in particular hypochondriasis, depression and hysteria, were highly elevated in approximately 50% of the patients and correlated with the severity of neurological symptoms (i.e., pain). Patients with Parkinson's disease had similar abnormal personality profiles. This resemblance between both patient groups indicates that psychiatric symptoms in ST are nonspecific and represent the consequence of a chronic disabling disease. Since among ST patients no distinct patterns of symptoms, psychiatric or psychological variables were found, no clinically relevant subgroup could be identified.