Social cognition in cervical dystonia: phenotype and relationship to anxiety and depression

B Ellement; Y Jasaui; K Kathol; E Nosratmirshekarlou; T Pringsheim; J Sarna; B L Callahan; D Martino

doi:10.1111/ene.14508

Social cognition in cervical dystonia: phenotype and relationship to anxiety and depression

Eur J Neurol. 2021 Jan;28(1):98-107. doi: 10.1111/ene.14508. Epub 2020 Sep 30.

Authors

B Ellement¹, Y Jasaui², K Kathol^{3

4}, E Nosratmirshekarlou^{3

5

6}, T Pringsheim^{3

5

6

7}, J Sarna³, B L Callahan^{1

6

7}, D Martino^{3

6

7}

Affiliations

¹ Department of Psychology, University of Calgary, Calgary, AB, Canada.
² Continuing Medical Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
³ Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁴ Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.
⁵ Department of Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
⁶ Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.
⁷ Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.

PMID: 32896024
DOI: 10.1111/ene.14508

Abstract

Background and purpose: Anxiety and depression are common disabling comorbidities in cervical dystonia (CD) and may predispose to social withdrawal and social cognitive impairments. The relationship between social cognition and depressive/anxiety symptoms in CD is under-investigated.

Methods: Forty-six CD patients (40 women; mean age ± SD, 55.57 ± 10.84 years) were administered the following social cognition battery: Affect Naming, Prosody Face and Pair Matching subtests from the Wechsler Adult Intelligence Scale IV and Wechsler Memory Scale IV (social perception), reality-known and reality-unknown false belief reasoning tasks (theory of mind), Empathy Quotient and Social Norms Questionnaire 22 (social behaviour), alongside the Benton Facial Recognition Task (non-emotional facial discrimination). Alongside CD severity, the Hospital Anxiety and Depression Scale measured depressive/anxiety comorbid diagnostic status and severity, and the Liebowitz Social Anxiety Scale assessed social phobia. Social cognition tasks were standardized using published normative data and a cut-off of z < -1.5 for impairment.

Results: More than 90% of our CD patients performed normally on social perception and social behaviour tests. Performance on impaired belief reasoning (theory of mind) was impaired in 10 of 46 (21.74%); five of 46 (10.87%) were impaired on the Empathy Quotient. Better performance on the Affect Naming task was associated with comorbid anxiety (η² = 0.09, medium-to-large effect size) and greater anxiety, depression and social phobia severity. Worse performance on the Empathy Quotient was associated with comorbid depression (η² = 0.11, medium-to-large effect size) and greater depression severity. CD patients had significantly more difficulties with fearful face identification (P < 0.001).

Conclusions: Greater social perception abilities in CD patients with more severe anxiety and depression suggest efficient modulation and self-adaptation of social cognitive skills.

Keywords: adult onset dystonia; anxiety; cervical dystonia; depression; neurological disorders; psychiatric disorders; social cognition.

MeSH terms

Adult
Anxiety / epidemiology
Cognition
Depression* / epidemiology
Female
Humans
Neuropsychological Tests
Phenotype
Social Cognition
Torticollis*