Objective: To examine the relationship between psychosocial factors and tremor severity in patients with essential tremor (ET).

Background: Essential tremor is one of the most common movement disorders and may substantially impair quality of life. Tremor severity may be related not only to neurological mechanisms but also to psychosocial factors such as stress, anxiety, depression, reduced social support, low self-esteem, impaired quality of life, and perceived stigma. However, studies evaluating these associations in detail remain limited. This study aimed to investigate the association between psychosocial factors and tremor severity in ET.

Method: Forty-one patients with a diagnosis of ET were included. Tremor severity was assessed using the Fahn–Tolosa–Marin (FTM) scale, and patients were categorized into mild, moderate, and severe groups. Psychosocial measures included the Hospital Anxiety and Depression Scale (HADS), the SF-36 Quality of Life questionnaire, the Perceived Stress Scale (PSS-14), the Multidimensional Scale of Perceived Social Support (MSPSS), the Rosenberg Self-Esteem Scale, and a stigma scale for chronic illness. Associations between tremor severity and psychosocial variables were examined using ANOVA, correlation analyses, and regression models.

Results: Significant associations were observed between tremor severity and multiple psychosocial factors. Higher tremor severity was associated with higher anxiety levels (p<0.05) and positively correlated with perceived stress (p<0.05). Lower quality of life and lower self-esteem were associated with greater tremor severity (p<0.05). Patients reporting higher perceived stigma had markedly more severe tremor (p<0.05). No significant difference was observed for depression.

Conclusion: In ET, tremor severity appears to be associated with psychosocial factors and not solely with motor symptom burden. Higher anxiety, higher perceived stress, and greater perceived stigma were associated with more severe tremor, whereas better quality of life and higher self-esteem were associated with milder tremor. These findings support incorporating psychosocial assessment and supportive interventions alongside pharmacological treatment in ET management. Larger studies are warranted to confirm these results and inform patient-support programs.

References: This work was submitted to ADPD 2026 and has not been published to date.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-psychosocial-factors-and-tremor-severity-in-essential-tremor/