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Psychiatric comorbidity is common in dystonia and other movement disorders

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Michelle S. Lorentzos, Isobel Heyman, Benjamin J. Baig, Anna E. Coughtrey, Andrew McWilliams, David R. Dossetor, Mary Clare Waugh, Ruth A. Evans, Josie Hollywood, Joshua Burns, Manoj P. Menezes, Shekeeb S. Mohammad, Padraig Grattan-Smith, Kathleen M. Gorman, Belinda H.A. Crowe, Robert Goodman, Manju A. Kurian, Russell C. Dale

Original languageEnglish
Article number319541
JournalArchives of Disease in Childhood
Accepted/In press1 Jan 2020

King's Authors


Objective: To determine rates of psychiatric comorbidity in a clinical sample of childhood movement disorders (MDs). Design: Cohort study. Setting: Tertiary children's hospital MD clinics in Sydney, Australia and London, UK. Patients: Cases were children with tic MDs (n=158) and non-tic MDs (n=102), including 66 children with dystonia. Comparison was made with emergency department controls (n=100), neurology controls with peripheral neuropathy or epilepsy (n=37), and community controls (n=10 438). Interventions: On-line development and well-being assessment which was additionally clinically rated by experienced child psychiatrists. Main outcome measures: Diagnostic schedule and manual of mental disorders-5 criteria for psychiatric diagnoses. Results: Psychiatric comorbidity in the non-tic MD cohort (39.2%) was comparable to the tic cohort (41.8%) (not significant). Psychiatric comorbidity in the non-tic MD cohort was greater than the emergency control group (18%, p<0.0001) and the community cohort (9.5%, p<0.00001), but not the neurology controls (29.7%, p=0.31). Almost half of the patients within the tic cohort with psychiatric comorbidity were receiving medical psychiatric treatment (45.5%) or psychology interventions (43.9%), compared with only 22.5% and 15.0%, respectively, of the non-tic MD cohort with psychiatric comorbidity. Conclusions: Psychiatric comorbidity is common in non-tic MDs such as dystonia. These psychiatric comorbidities appear to be under-recognised and undertreated.

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