Stigma and quality of life for patients with facial dystonia: a cross-sectional study
Abstract Background Facial appearance and expressions influence social interaction. However, few studies have reported on the stigma associated with spasms from facial dystonia. This study investigated the stigma and quality of life for these patients. Methods This cross-sectional study included 90 patients with facial dystonia (hemifacial spasm [HFS], blepharospasm [BSP], and blepharospasm-oromandibular dystonia [BOD]; 30 patients per group) and 30 individuals without dystonia (control group) from October 2019 to November 2020. All participants underwent stigma, quality of life, and mental health evaluations using seven questions related to stigma, the 36-item Short Form Health Survey, the 14-item version of the Hamilton Anxiety Scale (HAMA), and the 24-item version of the Hamilton Depression Scale. Results Nineteen patients (21.11%) felt stigmatized. Patients with BPS and HFS had more difficulty finding a job and were more susceptible to discrimination than healthy individuals. The role-physical and social function scores were significantly lower in the dystonia groups than in the control group. The vitality score of the BPS group and the mental health scores in the BPS and BOD groups were significantly less than those of the control group. The HAMA scores in the BPS and BOD groups were significantly higher than in the control group. Regression analysis demonstrated that the disease course influenced depression. Conclusion Enacted stigma from a negative public attitude may be the main factor triggering stigma in patients with facial dystonia, with detrimental effects on psychosocial outcomes, including social rights, quality of life, and mood.