The Limited Role of Psychotherapy In Torsion Dystonia

The number of physicians consulted before diagnosis and the results of psychiatric treatment were recorded for 44 patients in whom torsion dystonia (TD) developed. Twenty-three of these patients saw six or more physicians before the diagnosis was established. This probably reflects the absence of any single physical or biochemical abnormality characteristic of the hereditary dystonias and the general unfamiliarity of the medical profession with these diseases. Of the 24 patients who had a trial of psychotherapy, seven reported that their general condition was made worse, 12 reported no effect, and five reported benefit in emotional status but not in dystonic symptoms. In three helped by psychotherapy, the diagnosis of TD had already been made and treatment was aimed, not at curing the movement disorder, but at assisting the patient and family to adjust to the disease.