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Longitudinal study of mood disorder and health-related quality of life in cervical dystonia

Cervical dystonia is an inherited movement disorder causing involuntary excessive movements of the neck muscles causing the head to turn and twist without control. The cause of cervical dystonia is unknown; it is treated with botulinum toxin injections. 300 people with cervical dystonia attend the Specialist clinic at St Vincent’s University Hospital. Anxiety and depression affect about 50-60% of patients and is poorly understood. We consider that the anxiety & depression are part of the primary disorder and caused by the same mechanisms, which causes the movement disorder. Anxiety and depression cause significant impairment in health-related quality of life. 2 years ago, we assessed the prevalence of anxiety and depression in 201 patients with cervical dystonia and in the present study we propose to reassess these patients to determine the persistence of significant anxiety and depression. This will form the basis for the recruitment of cervical dystonia patients into a proposed randomized controlled trial of an SSRI. The present evidence is that, even with best current medical treatment using botulinum toxin, a significant proportion of patients with cervical dystonia have ongoing significant anxiety and depression with resultant impairment health-related quality of life which requires to be addressed. This present study will form the basis of this proposed intervention.