Anxiety and social anxiety severity vary by onset site of focal dystonia, and this variation is not explained by differences in pain and dystonia severity, according to a recent study.

Patients with isolated focal dystonia evaluated within 5 years from symptom onset who were enrolled in the Natural History Project of the Dystonia Coalition were included in the analysis; 478 subjects met the inclusion criteria. Individual onset sites were grouped into 5 body regions: cervical, laryngeal, limb, lower cranial, and upper cranial. Researchers found:

• High levels of depression, anxiety and social anxiety occurred in all groups; however, the severity of anxiety and social anxiety symptoms varied by onset site group.
• The most pronounced differences were higher anxiety in cervical and laryngeal, lower anxiety in upper cranial, and higher social anxiety in laryngeal.
• Increases in pain were associated with worse neuropsychiatric symptom scores within all groups.
• Higher anxiety and social anxiety in laryngeal and lower anxiety in upper cranial persisted after correcting for pain and dystonia severity.