Botulinum Toxin Treatment of Spasmodic Torticollis: Effects on Psychosocial Function

  • Marjan Jahanshahi
  • C. David Marsden


In torticollis, depression can be either secondary to the onset and experience of living with the illness or result from the primary central neurotransmitter dysfunction. The results of a number of previous studies have suggested that in torticollis depression may develop as a reaction to the postural abnormality of the head. One hundred patients with torticollis were more depressed than an equally chronic group of cervical spondylosis sufferers (Jahanshahi & Marsden, 1988). In torticollis, depression centered around a negative view of the self and disfigurement accounted for 14% of its variance (Jahanshahi & Marsden, 1990a). In a sample of 67 torticollis patients, a number of psychosocial variables (self-deprecation, satisfaction with available social support, maladaptive coping) together with disability and extent of control over head position accounted for 75% of the variance in depression. The self-deprecation associated with the negative body concept resulting from the postural abnormality emerged as the major predictor of depression (Jahanshahi, 1991). Longitudinal follow-up of these patients over 2.5 years showed that change in the clinical status of torticollis had a significant effect on depression, disability, and body concept (Jahanshahi & Marsden, 1990b).


Botulinum Toxin Neck Pain Botulinum Toxin Injection Maladaptive Coping Postural Abnormality 
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Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • Marjan Jahanshahi
    • 1
  • C. David Marsden
    • 1
  1. 1.Medical Research Council Human Movement & Balance Unit & Department of Clinical NeurologyInstitute of Neurology The National Hospital for Neurology & Neurosurgery Queen SquareLondonUK

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