Past clinical research has identified depression as the most common psychiatric disorder associated with cervical dystonia (CD). The purpose of our study is to document different patterns of psychopathology, the frequency of psychiatric disorders, and possible correlation with the neurological disorder in patients with CD. Forty patients with CD were investigated to assess levels of psychopathology on two self-rated scales: the Beck Depression Inventory (BDI) and Symptom Check List (SCL-90). To determine the presence of psychiatric disorders, the patients were evaluated using the standard instrument in the DSM-III-R (Structured Clinical Interview Schedule, SCID). A small group of dystonic patients (12%) had higher levels of psychopathology, with significant amounts of concomitant anxiety and depression on the BDI and SCL-90. SCID criteria for at least one psychiatric disorder were fulfilled in 22 patients (55%), including both the lifetime and current diagnoses. The most frequent diagnostic categories were anxiety (40%) and major depressive disorders (37.5%). In 17 patients (42.5%), criteria for at least one lifetime diagnosis were fulfilled prior to the onset of CD. Psychiatric evaluation does not indicate one specific disorder associated with CD. The presence of anxiety and depression symptoms before and during the course of dystonia, without a possible causal relationship, could mean that the alteration of a chain of physiological events in the central nervous system may not lead to a single clinical picture. The relatively high overall lifetime prevalence of anxiety and depressive disorders may indicate the need for a broader diagnostic and therapeutic approach to patients with focal dystonia. Depression and Anxiety 16:100–103, 2002.

THE GLOBUS sensation, a feeling of a lump in the throat associated with dry swallowing and disappearing while eating or drinking, has been widely regarded as psychogenic. It was thought to be a "materialization of a repressed idea,"¹ "one of the most widely recognized indications of nervous illness,"² "a physical manifestation of suppressed emotion,"³ a "discriminant symptom of somatization disorder,"⁴ or a "single-symptom model for the study of conversion disorders."⁵ The last proposition was based on no more than higher neuroticism and lower extraversion scores on the Eysenck Personality Inventory⁶ in 37 women with globus sensation compared with 24 normal control subjects. The same group of authors later reported to have found significantly higher neuroticism scores on the Eysenck Personality Inventory and significantly higher ratings of anxiety, obsessionality, depression, phobia, and somatic concern in 28 women with the sensation than in 33 without it.⁷ Other authors found patients with the sensation to have no more anxiety and hysterical traits than healthy subjects^8-10 and outpatients with otolaryngological disorders.^11,12

Numerous findings indicate alterations in brain serotonin systems in obsessive-compulsive disorder (OCD). We investigated the in vivo availability of thalamus–hypothalamus serotonin transporters (SERT) in patients with DSM-IV OCD who displayed prominent behavioral checking compulsions (OC-checkers). Four hours after injection of [¹²³I]-2β-carbomethoxy-3β-(4-iodophenyl)tropane ([¹²³I]-β-CIT), single photon emission computed tomography (SPECT) scans were performed in 24 medication-free non-depressed OC-checkers and 24 age- and gender-matched healthy controls. For quantification of brain serotonin transporter availability, a ratio of specific to non-displaceable [¹²³I]-β-CIT brain binding was used (V″₃=(thalamus and hypothalamus−cerebellum)/cerebellum). Drug-free non-depressed OC-checkers showed an 18% reduced brain serotonin transporter availability in the thalamus and hypothalamus, as compared with healthy control subjects (1.38±0.19 vs 1.69±0.21; p<0.001). There was a strong negative correlation between severity of OC symptomatology (Y-BOCS scores) and SERT availability (r=−0.80; p<0.001). Moreover, we found a significant positive correlation between illness duration and serotonin transporter availability (r=0.43; p<0.05). This first report of significantly reduced [¹²³I]-β-CIT binding in the thalamus–hypothalamus region in OC-checkers suggests reduced brain serotonin transporter availability, which is more pronounced with increased severity of OC symptomatology and short duration of illness. The results provide direct evidence for an involvement of the serotonergic system in the pathophysiology of OCD.

Little is known about the impact of the COVID-19 pandemic on the mental health and psychological well-being of young people. The aim of this study is to investigate the psychological well-being and changes in the mental-health state of young people living in Austria and Turkey. By using an anonymous online survey, we recruited 1240 people aged 15–25 years from these two countries. We used the “Psychological General Well-being” and a self-created questionnaire to capture individual experiences during the COVID-19 pandemic and quarantine period. The native Turks indicated higher “anxiety” (ps < 0.010), lower “vitality” (ps < 0.011), and lower “general health” (ps < 0.011) than native Austrians or Austrian migrants and increased “depression” (p = 0.005) and lower “self-control” (p = 0.022), than Austrian migrants. Moreover, 50.9% of native Turks reported a decrease in their mental health status, compared to 31.1% of native Austrians and 23.7% of Austrian migrants. Participants with financial problems (OR = 1.68) and prior mental health problems (i.e., already in treatment by the time of COVID-19, OR = 5.83) reported a higher probability for a worsening in their mental health status. Our results show that the COVID-19 pandemic impaired the psychological well-being and mental health of young people. Especially people in Turkey were most affected, probably due to the stringent policies to fight COVID-19.