Neuropsychiatric Approaches to Essential and Functional Tremor: A Comparative Study

神经精神病学方法在原发性震颤和功能性震颤中的应用:一项比较研究

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Abstract

PURPOSE: Differentiating essential tremor (ET) from functional tremor (FT) remains a challenge due to their overlapping clinical presentations. This study aimed to elucidate the demographic and psychometric differences between the aforementioned tremor types to enhance diagnostic accuracy and therapeutic strategies. PATIENTS AND METHODS: This prospective study included 96 patients diagnosed with ET or FT and analysed their related demographic data, clinical symptoms, and psychometric evaluation scores. The statistical analysis involved Pearson's chi-square tests, Fisher's exact tests, and logistic regression to determine how the different variables impact tremor diagnosis. RESULTS: Our study demonstrated a higher prevalence of ET in males (p = 0.015). Furthermore, we demonstrated that patients with ET displayed a significantly lower body mass index and a lower age of onset compared to those with FT (p = 0.050 and p = 0.023, respectively). Psychometric assessments revealed higher cognitive and body image scores in patients with ET, whereas those with FT scored higher on the depression and anxiety scales. The misdiagnosis rate was 14.5%, emphasising the requirement for improved diagnostic criteria. CONCLUSION: We established specific demographic and psychometric distinctions between ET and FT, which could potentially benefit clinicians in making accurate diagnoses and tailoring treatment approaches. These findings support the inclusion of comprehensive psychometric evaluations into standard diagnostic procedures to better differentiate tremor types.

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