Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T20:55:41.984Z Has data issue: false hasContentIssue false

Tardive dyskinesia: a 3-year follow-up study

Published online by Cambridge University Press:  09 July 2009

T. R. E. Barnes*
Affiliation:
Psychiatric Research Unit, University of Cambridge Clinical School; St Andrew's Hospital, Northampton; MRC Biostatistics Unit, Cambridge
T. Kidger
Affiliation:
Psychiatric Research Unit, University of Cambridge Clinical School; St Andrew's Hospital, Northampton; MRC Biostatistics Unit, Cambridge
S. M. Gore
Affiliation:
Psychiatric Research Unit, University of Cambridge Clinical School; St Andrew's Hospital, Northampton; MRC Biostatistics Unit, Cambridge
*
1 Address for correspondence: Dr T. R. E. Barnes, Psychiatric Research Unit, Old Addenbrooke's Hospital, Trumpington Street, Cambridge CR2 2QE.

Synopsis

A prospective study of tardive dyskinesia was carried out to gain information regarding the natural history of the condition and to identify risk factors. Out of an original cohort of 182 psychiatric patients receiving maintenance antipsychotic drugs 99 were available for reassessment after 3 years. In this follow-up group the point prevalence of oro-facial dyskinesia increased from 39% to 47% over the 3-year period. Twenty-two patients developed the disorder, while remission occurred in 14 others. Risk factors predicting the presence of oro-facial dyskinesia at follow-up included being over 50 years of age and the presence of akathisia. There was no convincing association between the duration of antipsychotic drug treatment and the presence or severity of oro-facial dyskinesia. Patients receiving over 1000mg chlorpromazine equivalents of antipsychotic drug per day were unlikely to have the condition. The amount of purposeless trunk and limb movement present proved to be a relatively stable phenomenon, showing only a slight increase with age and no change over the follow-up period. The implications of these findings are discussed, with particular consideration being given to the effects of loss of patients to follow-up.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1983

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American College of Neuropsychopharmacology - Food and Drink Administration Task Force. (1973). Drug therapy. Neurologic syndromes associated with antipsychotic drug use. New England Journal of Medicine 289, 2023.CrossRefGoogle Scholar
Anderson, J. A. & Phillips, P. R. (1981). Regression, discrimination and measurement models for ordered categorical variables. Applied Statistics 30, 2231.CrossRefGoogle Scholar
Ayd, F. J. (1961). A survey of drug-induced extrapyramidal reactions. Journal of the American Medical Association 175, 10541060.CrossRefGoogle ScholarPubMed
Barnes, T. R. E. & Trauer, T. (1982). Reliability and validity of a tardive dyskinesia videotape rating technique. British Journal of Psychiatry 140, 508515.CrossRefGoogle ScholarPubMed
Brandon, S., McClelland, M. A. & Protheroe, C. (1971). A study of facial dyskinesia in a mental hospital population. British Journal of Psychiatry 118, 171184.CrossRefGoogle Scholar
Carpenter, W. T., Rey, A. C. & Stephens, J. H. (1980). Covert dyskinesia in ambulatory schizophrenia. Lancet ii, 212213.CrossRefGoogle Scholar
Davis, J. M. (1974). Dose equivalence of the antipsychotic drugs. Journal of Psychiatric Research 11, 6569.CrossRefGoogle ScholarPubMed
Ezrin-Waters, C., Seeman, M. V. & Seeman, P. (1981). Tardive dyskinesia in schizophrenic outpatients: prevalence and significant variables. Journal of Clinical Psychiatry 42, 1622.Google Scholar
Fahn, S. (1978). Tardive dyskinesia may only be akathisia. New England Journal of Medicine 299, 202203.Google ScholarPubMed
Gardos, G., Cole, J. O. & Tarsy, D. (1978). Withdrawal syndromes associated with antipsychotic drugs. American Journal of Psychiatry 135, 13211324.Google ScholarPubMed
Gerlach, J. (1977). The relationship between parkinsonism and tardive dyskinesia. American Journal of Psychiatry 134, 781784.Google ScholarPubMed
Granacher, R. P. (1981). Differential diagnosis of tardive dyskinesia: an overview. American Journal of Psychiatry 138, 12881297.Google ScholarPubMed
Jeste, D. V. & Wyatt, R. J. (1981). Changing epidemiology of tardive dyskinesia: an overview. American Journal of Psychiatry 138, 297309.Google ScholarPubMed
Kane, J. M. & Smith, J. M. (1982). Tardive dyskinesia: prevalence and risk factors 1959–1979. Archives of General Psychiatry 39, 473481.CrossRefGoogle Scholar
Kidger, T., Barnes, T. R. E., Trauer, T. & Taylor, P. J. (1980). Sub-syndromes of tardive dyskinesia. Psychological Medicine 10, 513520.CrossRefGoogle ScholarPubMed
Klawans, H. L. (1973). The pharmacology of tardive dyskinesias. American Journal of Psychiatry 130, 8286.CrossRefGoogle ScholarPubMed
Raskin, D. E. (1972). Akathisia: a side effect to be remembered. American Journal of Psychiatry 129, 345347.CrossRefGoogle ScholarPubMed
Schonell, F. J. (1942). Test R2 (Simple Prose Reading Test). In Backwardness in Basic Subjects. Oliver & Boyd: Edinburgh.Google Scholar
Seeman, M. V. (1981). Tardive dyskinesia: two-year recovery. Comprehensive Psychiatry 22, 189191.Google Scholar
Simpson, G. M. (1977). Neurotoxicity of major tranquillisers. In Neurotoxicology, Vol. 1 (ed. Roizin, L., Shiraki, H. and Grčević, N.), pp. 17. Raven Press: New York.Google Scholar
Simpson, G. M. & Angus, J. W. S. (1970). A rating scale for extrapyramidal side-effects. Acta Psychiatrica Scandinavica 212 (suppl. 44), 1119.CrossRefGoogle ScholarPubMed
Smith, J. M. & Baldessarini, R. J. (1980). Changes in prevalence, severity, and recovery in tardive dyskinesia with age. Archives of General Psychiatry 37, 13681370.Google Scholar
Smith, R. C. & Leelavathi, D. E. (1980). Behavioral and biochemical effects of chronic neuroleptic drugs: interaction with age. In Tardive Dyskinesia: Research and Treatment (ed. Fann, W. E., Smith, R. C., Davis, J. M. and Domino, E. F.), pp. 6588. Spectrum Publications: New York.CrossRefGoogle Scholar
Van Putten, T. (1975). The many faces of akathisia. Comprehensive Psychiatry 16, 4347.CrossRefGoogle ScholarPubMed
Wyatt, R. J. & Togrow, J. S. (1976). A comparison of equivalent clinical potencies of neuroleptics as used to treat schizophrenia and affective disorders. Journal of Psychiatric Research 13, 9198.CrossRefGoogle Scholar