Cervical dystonia and substance abuse

For the members of the Dystonia Coalition

Research output: Contribution to journalComment/debate

Abstract

Objective: To investigate the prevalence of substance abuse (SA) in patients with cervical dystonia (CD) and to correlate it with prevalence of psychiatric disorders. Methods: Data on anxiety, depression, dystonia severity, and substance abuse were collected from ten sites participating in the Dystonia Coalition. Patients were divided into two groups according to the presence of SA, utilizing Structured Clinical Interview for DSM-4 criteria. Wilcoxon Rank-Sum test was used to analyze the difference in median scores on the questionnaires between the groups. Chi-square test was used to analyze association between opiate and benzodiazepine use and SA. Association between TWSTRS severity and SA and medication use was assessed. A two-tailed p value of < 0.05 was considered significant. SAS 9.3 (SAS Institute Inc., Cary, NC, USA) was used for all analyses. Results: Of 208 CD patients, 23 (11%) were identified with SA; 26.3% of patients with SA were on opiates compared to 7.2% of CD patients without SA (p = 0.006). Compared to non-SA patients, those experiencing SA were more likely male (88.9%; p = 0.0007), younger (median age 55; p = 0.031), and scored worse on questionnaires assessing depression (p = 0.044, p = 0.005), anxiety (p = 0.003), and dystonia psychiatric severity (p = 0.033). The median TWSTRS motor severity scores were higher in SA patients compared to non-SA patients (20 versus 16, p = 0.0339). The median TWSTRS total disability, motor, and pain scores were higher in patients on opiates than patients who were not (12 versus 8, p = 0.0071; 18.5 versus 16, p = 0.0243; 12.4 versus 6.7, p = 0.0052, respectively). Conclusions: Potential risk factors for SA in CD patients include younger age and male gender with comorbid anxiety, depression and other psychiatric problems. Caution should be exercised when prescribing drugs with potential for abuse in these patients.

Original languageEnglish (US)
Pages (from-to)970-975
Number of pages6
JournalJournal of Neurology
Volume265
Issue number4
DOIs
StatePublished - Apr 1 2018

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Torticollis
Substance-Related Disorders
Opiate Alkaloids
Dystonia
Psychiatry
Anxiety
Depression
Nonparametric Statistics
Drug Prescriptions
Chi-Square Distribution
Benzodiazepines

Keywords

  • Alcohol
  • Dystonia
  • Neuroepidemiology
  • Psychiatric disorders
  • Substance abuse

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

For the members of the Dystonia Coalition (2018). Cervical dystonia and substance abuse. Journal of Neurology, 265(4), 970-975. https://doi.org/10.1007/s00415-018-8840-9

Cervical dystonia and substance abuse. / For the members of the Dystonia Coalition.

In: Journal of Neurology, Vol. 265, No. 4, 01.04.2018, p. 970-975.

Research output: Contribution to journalComment/debate

For the members of the Dystonia Coalition 2018, 'Cervical dystonia and substance abuse', Journal of Neurology, vol. 265, no. 4, pp. 970-975. https://doi.org/10.1007/s00415-018-8840-9
For the members of the Dystonia Coalition. Cervical dystonia and substance abuse. Journal of Neurology. 2018 Apr 1;265(4):970-975. https://doi.org/10.1007/s00415-018-8840-9
For the members of the Dystonia Coalition. / Cervical dystonia and substance abuse. In: Journal of Neurology. 2018 ; Vol. 265, No. 4. pp. 970-975.
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abstract = "Objective: To investigate the prevalence of substance abuse (SA) in patients with cervical dystonia (CD) and to correlate it with prevalence of psychiatric disorders. Methods: Data on anxiety, depression, dystonia severity, and substance abuse were collected from ten sites participating in the Dystonia Coalition. Patients were divided into two groups according to the presence of SA, utilizing Structured Clinical Interview for DSM-4 criteria. Wilcoxon Rank-Sum test was used to analyze the difference in median scores on the questionnaires between the groups. Chi-square test was used to analyze association between opiate and benzodiazepine use and SA. Association between TWSTRS severity and SA and medication use was assessed. A two-tailed p value of < 0.05 was considered significant. SAS 9.3 (SAS Institute Inc., Cary, NC, USA) was used for all analyses. Results: Of 208 CD patients, 23 (11{\%}) were identified with SA; 26.3{\%} of patients with SA were on opiates compared to 7.2{\%} of CD patients without SA (p = 0.006). Compared to non-SA patients, those experiencing SA were more likely male (88.9{\%}; p = 0.0007), younger (median age 55; p = 0.031), and scored worse on questionnaires assessing depression (p = 0.044, p = 0.005), anxiety (p = 0.003), and dystonia psychiatric severity (p = 0.033). The median TWSTRS motor severity scores were higher in SA patients compared to non-SA patients (20 versus 16, p = 0.0339). The median TWSTRS total disability, motor, and pain scores were higher in patients on opiates than patients who were not (12 versus 8, p = 0.0071; 18.5 versus 16, p = 0.0243; 12.4 versus 6.7, p = 0.0052, respectively). Conclusions: Potential risk factors for SA in CD patients include younger age and male gender with comorbid anxiety, depression and other psychiatric problems. Caution should be exercised when prescribing drugs with potential for abuse in these patients.",
keywords = "Alcohol, Dystonia, Neuroepidemiology, Psychiatric disorders, Substance abuse",
author = "{For the members of the Dystonia Coalition} and Abhimanyu Mahajan and Joseph Jankovic and Laura Marsh and Achint Patel and Jinnah, {H. A.} and Cynthia Comella and Richard Barbano and Joel Perlmutter and Neepa Patel",
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T1 - Cervical dystonia and substance abuse

AU - For the members of the Dystonia Coalition

AU - Mahajan, Abhimanyu

AU - Jankovic, Joseph

AU - Marsh, Laura

AU - Patel, Achint

AU - Jinnah, H. A.

AU - Comella, Cynthia

AU - Barbano, Richard

AU - Perlmutter, Joel

AU - Patel, Neepa

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Objective: To investigate the prevalence of substance abuse (SA) in patients with cervical dystonia (CD) and to correlate it with prevalence of psychiatric disorders. Methods: Data on anxiety, depression, dystonia severity, and substance abuse were collected from ten sites participating in the Dystonia Coalition. Patients were divided into two groups according to the presence of SA, utilizing Structured Clinical Interview for DSM-4 criteria. Wilcoxon Rank-Sum test was used to analyze the difference in median scores on the questionnaires between the groups. Chi-square test was used to analyze association between opiate and benzodiazepine use and SA. Association between TWSTRS severity and SA and medication use was assessed. A two-tailed p value of < 0.05 was considered significant. SAS 9.3 (SAS Institute Inc., Cary, NC, USA) was used for all analyses. Results: Of 208 CD patients, 23 (11%) were identified with SA; 26.3% of patients with SA were on opiates compared to 7.2% of CD patients without SA (p = 0.006). Compared to non-SA patients, those experiencing SA were more likely male (88.9%; p = 0.0007), younger (median age 55; p = 0.031), and scored worse on questionnaires assessing depression (p = 0.044, p = 0.005), anxiety (p = 0.003), and dystonia psychiatric severity (p = 0.033). The median TWSTRS motor severity scores were higher in SA patients compared to non-SA patients (20 versus 16, p = 0.0339). The median TWSTRS total disability, motor, and pain scores were higher in patients on opiates than patients who were not (12 versus 8, p = 0.0071; 18.5 versus 16, p = 0.0243; 12.4 versus 6.7, p = 0.0052, respectively). Conclusions: Potential risk factors for SA in CD patients include younger age and male gender with comorbid anxiety, depression and other psychiatric problems. Caution should be exercised when prescribing drugs with potential for abuse in these patients.

AB - Objective: To investigate the prevalence of substance abuse (SA) in patients with cervical dystonia (CD) and to correlate it with prevalence of psychiatric disorders. Methods: Data on anxiety, depression, dystonia severity, and substance abuse were collected from ten sites participating in the Dystonia Coalition. Patients were divided into two groups according to the presence of SA, utilizing Structured Clinical Interview for DSM-4 criteria. Wilcoxon Rank-Sum test was used to analyze the difference in median scores on the questionnaires between the groups. Chi-square test was used to analyze association between opiate and benzodiazepine use and SA. Association between TWSTRS severity and SA and medication use was assessed. A two-tailed p value of < 0.05 was considered significant. SAS 9.3 (SAS Institute Inc., Cary, NC, USA) was used for all analyses. Results: Of 208 CD patients, 23 (11%) were identified with SA; 26.3% of patients with SA were on opiates compared to 7.2% of CD patients without SA (p = 0.006). Compared to non-SA patients, those experiencing SA were more likely male (88.9%; p = 0.0007), younger (median age 55; p = 0.031), and scored worse on questionnaires assessing depression (p = 0.044, p = 0.005), anxiety (p = 0.003), and dystonia psychiatric severity (p = 0.033). The median TWSTRS motor severity scores were higher in SA patients compared to non-SA patients (20 versus 16, p = 0.0339). The median TWSTRS total disability, motor, and pain scores were higher in patients on opiates than patients who were not (12 versus 8, p = 0.0071; 18.5 versus 16, p = 0.0243; 12.4 versus 6.7, p = 0.0052, respectively). Conclusions: Potential risk factors for SA in CD patients include younger age and male gender with comorbid anxiety, depression and other psychiatric problems. Caution should be exercised when prescribing drugs with potential for abuse in these patients.

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KW - Dystonia

KW - Neuroepidemiology

KW - Psychiatric disorders

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