Neuropsychiatric Department, Barberry National Centre for Mental Health, Birmingham, United Kingdom.
J Neuropsychiatry Clin Neurosci. 2021 Fall;33(4):295-306. doi: 10.1176/appi.neuropsych.20110293. Epub 2021 Jul 19.
The relationship between idiopathic and inherited (monogenic) forms of isolated and combined dystonia and psychiatric disorders remains unclear. In the present review, the authors aimed to provide increased clarity on this association through a systematic review of all controlled quantitative studies using a structured or semi-structured psychiatric interview to diagnose psychiatric disorders in individuals with these conditions.
Three databases were searched to identify 20 eligible studies, with a total of 1,275 participants fulfilling inclusion criteria. Eligible articles were quality appraised and divided into four sections (idiopathic forms of dystonia [N=11], early-onset torsion dystonia [N=2], gene mutation positive myoclonus dystonia; DYT-SGCE [N=6], and rapid-onset dystonia-parkinsonism [N=1]).
For each study, results were grouped into subcategories (overall psychiatric comorbidity, anxiety disorders, mood disorders, substance misuse, and other [personality disorder and cognitive impairment]). For idiopathic dystonia, higher rates of psychiatric comorbidity, including mood and anxiety disorders, were noted when cases were compared with both healthy control subjects and control groups with a medical comorbidity. However, for major depressive disorder and obsessive-compulsive disorder (OCD) specifically, no differences were seen between groups. Study subjects with DYT-SGCE appeared to be at higher risk of psychiatric comorbidity, major depressive disorder, OCD, and alcohol dependence than control populations.
Overall, the prevalence of psychiatric comorbidity appears to be increased in individuals with idiopathic and inherited (monogenic) forms of isolated and combined dystonia compared with control subjects. This finding is not consistent for all comparisons, and further research is required to understand the nature of these associations and the underlying causative etiologies.
特发性和遗传性（单基因）孤立性和混合性肌张力障碍与精神障碍之间的关系仍不清楚。在本综述中，作者旨在通过系统综述所有使用结构化或半结构化精神科访谈来诊断这些疾病患者精神障碍的对照定量研究，以更清楚地了解这种关联。
通过搜索三个数据库，确定了 20 项符合条件的研究，共有 1275 名符合纳入标准的参与者。对合格的文章进行了质量评估，并分为四部分（特发性肌张力障碍[N=11]、早发性扭转痉挛[N=2]、基因突变阳性肌阵挛性肌张力障碍；DYT-SGCE[N=6]和快速进展性肌张力障碍-帕金森病[N=1]）。
对于每项研究，结果分为亚组（总体精神共病、焦虑障碍、心境障碍、物质滥用和其他[人格障碍和认知障碍]）。与健康对照组和伴有医学合并症的对照组相比，特发性肌张力障碍患者的精神共病率更高，包括心境和焦虑障碍。然而，对于重度抑郁症和强迫症（OCD），两组之间没有差异。与对照组相比，DYT-SGCE 研究对象似乎更易患精神共病、重度抑郁症、强迫症和酒精依赖。
总体而言，与对照组相比，特发性和遗传性（单基因）孤立性和混合性肌张力障碍患者的精神共病患病率似乎更高。但并非所有比较都如此，需要进一步研究以了解这些关联的性质和潜在的因果病因。
