Personality and psychopathological profile of patients and botulinum therapy for blepharospasm

Background. Blepharospasm (BS) includes non-motor symptoms manifested by psychopathological disorders. The impact of these disorders on patients' quality of life and therapy of motor symptoms with botulinum toxin is poorly understood.

Aim. To analyze the correlation of different characterological personality abnormalities (CPA) with the BS severity and the response to botulinum toxin therapy (BT).

Materials and methods. Forty-six BS patients (29 females, 17 males) aged 30 to 85 years (61±11.5) with BS were examined. The control group included 46 healthy individuals (39 females and 7 males, with a mean age of 56.4±9.67). Patients were examined before and after BT (after 12 months) using the BS severity scale (BSDI), EQ-5D (EQ-5D-3L) quality of life assessment scales, General Anxiety Disorder (GAD-7) scale, Brief Fear of Negative Evaluation Scale (BFNE-S), and SCID-II-PD structured personality questionnaire.

Results. In the BS group of patients, unemployed and non-married were more common (p<0.05) than in healthy individuals. In the BS patient group, there was an increase in anxiety (15.52±5.6 vs 4.28±3.5 control group by GAD-7 scale) and fear of negative evaluation (42.44±9.2 in the main group vs 21.34±7.3 in the control group). Quality of life was lower in BS patients (65.43, median 62 vs 88.2, median 92, p<0.05). The prevalence of cluster C CPA (anxiety disorders) in patients with BS and, in particular, the obsessive-compulsive disorder was revealed. Patients with different personality profiles showed no differences in the BS severity before BT. The BT efficacy was higher in patients with cluster C CPA.

Conclusion. BS patients often have anxious type CPA; in these patients, BT is more effective than in other CPAs.