Reliability of DNMSQuest as a Screening Tool for Mood Disorders in Cervical Dystonia

Abstract

Background The high prevalence of mood disorders in cervical dystonia, often unaddressed in botulinum toxin clinics, is a major factor in impaired quality of life. There is a clear need for a brief screening method for identifying these disorders; the Dystonia non‐motor symptoms questionnaire (DNMSQuest) has been proposed as such. Objective We aimed to assess the practical utility of the DNMSQuest and compare it with validated rating scales for anxiety, depression and quality of life. Methods In 88 patients with cervical dystonia, we compared results from the DNMSQuest with mood rating scales [Beck Anxiety Inventory (BAI), Beck Depression Index (BDI‐II) and Hospital Anxiety and Depression Scale (HADS)], quality of life measures [European Quality of Life (EQOL) and European Quality of Life Visual Analogue Scale (EQOLVAS)] and with assessments of dystonia severity [Cervical Dystonia Impact Profile‐58 (CDIP58) and Toronto Western Rating Scale for Spasmodic Torticollis (TWSTRS)]. Results Using a cut off score on the DNMSQuest of 5, we noted that DNMSQuest had a sensitivity of 85% for detecting anxiety and depression using the BAI and BDI‐II, and 76% and 78% for anxiety and depression respectively using the HADS. The DNMSQuest correlated strongly with BAI (ρ = 0.715), BDI‐II (ρ = 0.658), HADS‐Anxiety (ρ = 0.616), HADS‐Depression (ρ = 0.706), EQOL (ρ = 0.653) and CDIP‐58 (ρ = 0.665). Conclusion The DNMSQuest is a brief, sensitive and non‐specific instrument for identifying patients that warrant further review for anxiety and depression and can easily be implemented in a neurologist‐run botulinum toxin clinic.

Non‐Motor Symptoms and Quality of Life in Patients withPRRT2‐Related Paroxysmal Kinesigenic Dyskinesia

“…It also plays a role in non‐motor processes such as cognition, sleep, and emotional regulation 11,12 . Growing evidence indicates that non‐motor manifestations are part of the clinical spectrum in various dystonic disorders, including idiopathic adult‐onset focal dystonia and genetic forms of dystonia 13–18 . Non‐motor manifestations can be an important determinant of health‐related quality of life (HrQoL), beyond the motor symptoms 15,16,19–23 .…”

“… 11 , 12 Growing evidence indicates that non‐motor manifestations are part of the clinical spectrum in various dystonic disorders, including idiopathic adult‐onset focal dystonia and genetic forms of dystonia. 13 , 14 , 15 , 16 , 17 , 18 Non‐motor manifestations can be an important determinant of health‐related quality of life (HrQoL), beyond the motor symptoms. 15 , 16 , 19 , 20 , 21 , 22 , 23 Perceived stigmatization and diminished self‐esteem can also influence quality of life in dystonic disorders.…”

“… 13 , 14 , 15 , 16 , 17 , 18 Non‐motor manifestations can be an important determinant of health‐related quality of life (HrQoL), beyond the motor symptoms. 15 , 16 , 19 , 20 , 21 , 22 , 23 Perceived stigmatization and diminished self‐esteem can also influence quality of life in dystonic disorders. 24 , 25 , 26 However, HrQoL, non‐motor manifestations, self‐esteem, and stigma have been poorly studied to date in patients with paroxysmal dystonic disorders, with only a few pilot findings.…”