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Behavioural Neurology
Volume 3, Issue 4, Pages 233-246

A Longitudinal Follow-up Study of Depression, Disability, and Body Concept in Torticollis

M. Jahanshahi and C. D. Marsden

MRC Human Movement & Balance Unit & Department of Clinical Neurology, Institute of Neurology, The National Hospital, Queen Square, London, WC1N 3BC, UK

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Changes in depression, disability, body concept, and severity of head deviation were examined in a sample of 67 patients with idiopathic torticollis, who were reassessed 2 years after taking part in an initial study (before the use of botulinum toxin injections). Over the follow-up period, torticollis was unchanged in 41·8%, had improved in 26·9% and deteriorated in 31·3% of cases. The overall levels of depression, disability, and body concept across the two occasions did not change. Changes in the clinical severity of torticollis over the follow-up period had a significant effect on psychological adjustment. Those whose torticollis improved were less depressed and disabled and a had a more positive body concept compared to the patients whose torticollis had worsened. Measures of illness severity had stronger associations with measures of psychological adjustment at follow-up than at the time of initial study. Longer duration of torticollis was associated with larger increases in depression and disability during the 2 years of follow-up. The results suggest that the experience of depression, disability, and negative body concept in a proportion of torticollis sufferers is a reaction to the neurological illness. A minority of the patients who remain chronically depressed are primary candidates for therapeutic intervention aiming at improving their adjustment to the illness.