A pilot study on efficacy and tolerability of cognitive behavioral therapy (CBT-FD) for Japanese patients with focal dystonia

Abstract

Background: Abnormal involuntary movement disorders such as dystonia are likely to be affected by a person's psychological state. Nevertheless, reports of the literature describing investigations of psychological interventions to dystonic patients are scarce. Patients with focal dystonia (FD) are left to confront various psychosocial difficulties. Ioannou and colleagues proposed a holistic approach to seek mechanisms of the basal ganglia associated with athletic performance from the perspective of neuro-psycho-motor-cognitive perspective. This viewpoint endorses that treatment is not as simple as being solitary: Rather, it must incorporate physical, psychological, and social aspects. Empirical intervention studies using psychotherapy are urgently necessary. Aim: The purpose of this study was to examine the efficacy and tolerability of cognitive behavioral therapy (CBT: hereinafter, CBT-FD) in mental health and dystonia symptoms of patients with FD. This report is the first study of Japanese patients with FD followed up for one year after CBT-FD intervention. Methods: We administered 8 sessions of CBT-FD to 15 patients without history of mental disorders who had focal dystonia and a score of 14 or higher on the Beck Inventory-II. We evaluated the effectiveness and tolerability of CBT-FD. Results: Significant improvements were found in many scales. Most improvements were sustained for one year. Improvement of dysfunction occurred independently of a decrease in depression and anxiety levels. Conclusions: Results of this study suggest that CBT-FD is effective for improving patient depression, anxiety, disability, pain, and quality of life including relation with the environment. We verified that CBT-FD contributes safely to holistic recovery.