Journal of Parkinson's Disease and Movement Disorders

Miray Erdem1, Elif Banu Söker1, Şencan Buturak1, Mehmet Balal2

1Sağlık Bilimleri Üniversitesi, Adana Şehir Hastanesi, Nöroloji Kliniği, Adana, Türkiye
2Bağımsız Araştırmacı, Nöroloji, Adana, Türkiye

Keywords: Anxiety, body image, functional movement disorder, impulsivity, psychiatric evaluation.

Abstract

Background: The primary objective of this study was to compare demographic, clinical, and comprehensive psychometric scale profiles between patients diagnosed with functional movement disorder (FMD) presenting with isolated motor phenomenology versus those with multiple clinical phenotypes.

Materials and Methods: A total of 93 consecutive patients diagnosed with FMD based on clinical criteria were included in the study. According to clinical examination findings, patients were divided into two main categories: the Isolated Movement Disorder Group (n = 63) and the Multiple Movement Disorder Group (n = 30). Patients undergoing active psychotropic medication therapy were excluded. All participants were administered the Standardized Mini-Mental State Examination (SMMSE), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Buss-Perry Aggression Questionnaire (BPAQ), Barratt Impulsivity Scale-11 (BIS-11), and Body Image Satisfaction Scale (BISS).

Results: No statistically significant differences were found between the isolated and multiple groups regarding age, age at onset, disease duration, SMMSE, BDI, BPAQ, BIS-11, and BISS scores (p > 0.05). Conversely, BAI scores were statistically significantly higher in the multiple motor phenotype group (19.77 ± 12.97 vs. 12.71 ± 8.43; p = 0.0096, adjusted p = 0.0288, Cohen's d = 0.69). Multivariable logistic regression confirmed that anxiety was independently associated with the multiple FMD phenotype (aOR = 1.071, 95% CI: 1.015-1.130, p = 0.012). In the gender-based subgroup analysis of the isolated group, BPAQ scores were significantly higher in female patients (48.14 ± 21.28 vs. 36.15 ± 16.79; p = 0.0152, Cohen's d = 0.62).

Conclusion: The complexity of the motor phenotype in FMD is independently associated with elevated anxiety levels. Comprehensive screening for anxiety is recommended in patients presenting with multiple motor phenomenology.