Medina Escobar Alex, Pringsheim Tamara, Goodarzi Zahra, Martino Davide
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, AB, Canada; Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Neurosci Biobehav Rev. 2021 Jun;125:221-230. doi: 10.1016/j.neubiorev.2021.02.036. Epub 2021 Mar 1.
Adult onset idiopathic dystonia (AOID) is the third most common movement disorder in adults. Co-existing depressive symptoms and disorders represent major contributors of disability and quality of life in these patients, but their prevalence remains unclear. We investigated the point prevalence of supra-clinical threshold depressive symptoms/depressive disorders in AOID in a systematic review with qualitative synthesis and meta-analysis. Our search identified 60 articles suitable for qualitative synthesis and 54 for meta-analysis. The overall pooled prevalence of either supra-clinical threshold depressive symptoms or depressive disorders was 31.5 % for cervical dystonia, 29.2 % for cranial dystonia, and 33.6 % for clinical samples with mixed forms of AOID. Major depressive disorder was more prevalent than dysthymia in cervical dystonia, whereas dysthymia was more prevalent in cranial dystonia. In cervical dystonia, the prevalence of supra-clinical threshold depressive symptoms screened by rating scales was higher than that of depressive disorders diagnosed with structured interviews. Prevalence studies using rating scales yielded higher heterogeneity. More research is warranted to standardize screening methodology and characterization of mood disorders in AOID.
成人起病型特发性肌张力障碍（AOID）是成人中第三常见的运动障碍。并存的抑郁症状和障碍是这些患者残疾和生活质量的主要影响因素，但其患病率仍不明确。我们通过系统评价、定性综合分析和荟萃分析，调查了AOID中超临床阈值抑郁症状/抑郁障碍的时点患病率。我们的检索确定了60篇适合定性综合分析的文章和54篇适合荟萃分析的文章。超临床阈值抑郁症状或抑郁障碍的总体合并患病率在颈部肌张力障碍中为31.5%，在头部肌张力障碍中为29.2%，在混合型AOID临床样本中为33.6%。在颈部肌张力障碍中，重度抑郁症比特发性抑郁障碍更常见，而在头部肌张力障碍中，持续性抑郁障碍更常见。在颈部肌张力障碍中，通过评定量表筛查出的超临床阈值抑郁症状的患病率高于通过结构化访谈诊断出的抑郁障碍的患病率。使用评定量表的患病率研究产生的异质性更高。有必要开展更多研究，以规范AOID中情绪障碍的筛查方法和特征描述。
