Objective: The objective of this study was to investigate comorbidities in cervical dystonia (CD) and effect of CD to retirement rate in Finland.

Background: Cervical dystonia is most common form of dystonia, the prevalence being 394 persons per million in Finland. The onset of CD is usually before 60 years of age, and even though CD does not reduce life expectancy, it may cause severe functional and psychosocial impairment in everyday life. Besides the motoric symptoms, recently non-motoric symptoms, especially psychiatric comorbidities, have been reported to occur in CD affecting substantially quality of life.

Methods: We studied the comorbidity in primary focal CD in Finland based on ICD-10 codes obtained from care registry and patient records of 937 confirmed adult primary focal CD patients between years 2007-2016. The retirement months and diagnosis of retirement were calculated from pension registry information. The results were compared to 3746 age and gender matched controls.

Results: Most prominent comorbidities with primary focal CD were depression (14%), anxiety (7%), and dorsalgia (11%)[table]. There was significantly more of retirement months before age of 65 years in CD group than in control (32,8 ± 67,2 vs.13,3 ± 47,1 months, p<10-5) [figure]. Also, the retirement age was significantly younger in CD patients compared to control group controls (56,1 ± 8,3 vs. 59,8 ± 6,7 years, p<10-5). Of the dystonia patients, who were retired because of sickness, the most common retirement diagnoses were dystonia (51%), depression (14%) and anxiety (8%). Patients with anxiety and depression had more of retirement months than other dystonia patients.

Conclusions: Cervical dystonia reduces considerably working ability and leads to earlier retirement. Anxiety and depression are most notable comorbidities, and co-occurrence of them further reduces more working ability. Spinal degenerative diseases were also common with CD, but they did not affect retirement rate significantly compared with control group. Our results suggest that more health care resources should be administered in treatment of CD to longer maintain working ability of CD patients. Further, psychiatric comorbidities should be taken into consideration in CD treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comorbidity-and-retirement-in-primary-focal-cervical-dystonia/