Objective: The objective of this study was to determine if there is a higher prevalence of psychiatric comorbidities, especially anxiety disorders, in orthostatic tremor (OT) patients compared to the general population.

Background: OT is a rare movement disorder characterized by a sensation of unsteadiness and high frequency tremors present while standing. Patients with OT often report a fear of falling and significant limitations in everyday activities. The prevalence of psychiatric comorbidities in OT patients is not well understood.

Methods: Twenty-nine OT patients were evaluated by trained psychiatry providers using the Mini International Neuropsychiatric Interview (M.I.N.I.). The MINI is a well validated screening tool for psychiatric disorders. We also obtained a complete, standardized history intake covering previous psychiatric symptoms and illnesses.

Results: Subject’s mean age was 67.75 years with female preponderance (89.3%). The average disease duration was 18.2 years. Most OT patients (58.6%) had seen a mental health professional during the illness course. During the standardized history intake, 25% of patients had a past history of depression, and 10.7% reported to have family history of any psychiatric condition. Thirty-eight percent of the patients screened positive for agoraphobia. Also, 38% of the patients screened positive for any anxiety disorders. Nine percent of patients were classified as having a major depressive episode with 6.9% at risk for suicide.

Conclusions: Prevalence of psychiatric comorbidities seems to be high in OT, especially anxiety-spectrum disorders. Further studies are needed to understand if psychiatric disorders appear as a secondary response to the patient’s symptoms, or are a primary non-motor manifestation of OT.

References: [1] KM Heilman. Orthostatic tremor, Arch.Neurol. 41 (1984) 880-881

[2] DV Sheehan, Y Lecrubier, KH Sheehan, P Amorim, J Janavs, E Weiller, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J.Clin.Psychiatry. (1998).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/psychiatric-comorbidities-are-common-in-patients-with-orthostatic-tremor/