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Heterogeneity of Tardive Dyskinesia

A Multivariate Analysis

Published online by Cambridge University Press:  02 January 2018

William M. Glazer*
Affiliation:
Tardive Dyskinesia Clinic, Connecticut Mental Health Center; Yale University School of Medicine
Hal Morgenstern
Affiliation:
UCLA School of Public Health, Los Angeles
Donna Niedzwiecki
Affiliation:
Memorial Sloan-Kettering Cancer, New York
Jeffrey Hughes
Affiliation:
Newport Hospital, Rhode Island
*
Yale University School of Medicine, 34 Park Street, New Haven, Connecticut 06508, USA

Abstract

To determine whether tardive dyskinesia (TD) is a single abnormal movement syndrome or multiple syndromes involving different anatomical areas, we examined 228 out-patients diagnosed with TD at the Connecticut Mental Health Center in New Haven. Application of factor analysis to the seven anatomical severity scores of the Abnormal Involuntary Movement Scale yielded three statistically independent factors involving abnormal movements primarily of the jaw-tongue, face-lips, and extremities-trunk. Using logistic regression to predict the severity of these factors, we found that the severity of the orofacial scores was positively associated with age, schizoaffective or affective disorder, and living alone, while severity of non-orofacial movement was positively associated with current neuroleptic dose, non-use of psychiatric medication, and living alone. Our findings suggest that orofacial and non-orofacial dyskinetic movements may involve distinct clinical syndromes of TD, each having a different set of prognostic and, possibly, aetiological determinants.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

Appelbaum, P. (1982) Dyskinesia and unipolar depression. American Journal of Psychiatry, 139, 140152.CrossRefGoogle ScholarPubMed
Bobruff, A., Gardos, G., Tarsy, D., Rapkin, R., Cole, J. & Moore, P. (1981) Clonazepam and phenobarbital in tardive dyskinesia. American Journal of Psychiatry, 138, 178193.Google ScholarPubMed
Brandon, S., McClellan, H. A. & Protheroe, C. (1971) A study of facial dyskinesia in a mental hospital population. British Journal of Psychiatry, 118, 171184.CrossRefGoogle Scholar
Caine, E., Margolin, D., Brown, G. & Ebert, M. (1978) Gilles de la Tourette's syndrome, tardive dyskinesia, and psychosis in an adolescent. American Journal of Psychiatry, 135, 241243.Google Scholar
Casey, D. E. & Denney, D. (1977) Pharmacological characterization of tardive dyskinesia. Psychopharmacology, 54, 18.CrossRefGoogle ScholarPubMed
Cutler, N. R., Post, R. M., Rey, A. C. et al (1981) Depression-dependent dyskinesias in two cases of manic-depressive illness. New England Journal of Medicine, 304, 10881089.CrossRefGoogle ScholarPubMed
Davis, K. L., Berger, P. A. & Hollister, L. E. (1976) Tardive dyskinesia and depressive illness. Psychopharmacology Communications, 2, 125130.Google ScholarPubMed
DeMars, J. P. (1966) Neuromuscular effects of long-term phenothiazine medication, electroconvulsive therapy and leucotomy. Journal of Nervous and Mental Diseases, 143, 7379.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35, 837844.CrossRefGoogle ScholarPubMed
Engelhardt, D., Polizos, P. & Waizer, J. (1975) CNS consequences of psychotropic drug withdrawal in autistic children: a follow-up report. Psychopharmacology Bulletin, 11, 67.Google ScholarPubMed
Glazer, W. & Moore, D. (1981) A tardive dyskinesia clinic in a community mental health center. Hospital and Community Psychiatry, 32, 572574.Google Scholar
Glazer, W., Moore, D. C., Schooler, N. R., Morgenstern, H. & Brenner, L. (1984) Tardive dyskinesia: a discontinuation study. Archives of General Psychiatry, 41, 623627.CrossRefGoogle ScholarPubMed
Goswani, U., Narayanan, H. & Channabassavanna, S. (1985) A study of state-dependent reversal of tardive dyskinesia: phenomenological probe in humans. Journal of Clinical Psychopharmacology, 5, 4854.Google Scholar
Granacher, R. P. (1961) Differential diagnosis of tardive dyskinesia: an overview. American Journal of Psychiatry, 138, 12881297.Google Scholar
Greil, W., Haag, H., Rossnagl, G. & Ruther, E. (1985) Effect of anticholinergics on tardive dyskinesia: a controlled discontinuation study. British Journal of Psychiatry, 145, 304310.CrossRefGoogle Scholar
Hamer, R. M. (1982) Tongue, arms, face movement emough to assess dyskinesia. Clinical Psychiatry News, 10, 22.Google Scholar
Hollingshead, A. (1975) A Two Factored Index of Social Position (mimeographed booklet). New Haven: Yale University Press.Google Scholar
Hollister, L. E. (1973) Clinical Use of Psychotherapeutic Drugs. Springfield, Ill: Charles C. Thomas.Google ScholarPubMed
Karson, C., Jeste, D., Lewitt, P. & Wyatt, R. (1983) A comparison of two iatrogenic dyskinesias. American Journal of Psychiatry, 140, 15041506.Google ScholarPubMed
Kidger, T., Barnes, T. R. E., Trauer, T. & Taylor, P. J. (1980) Subsyndromes of tardive dyskinesia. Psychological Medicine, 10, 513520.CrossRefGoogle ScholarPubMed
Kleinbaum, D. G., Kupper, L. L. & Morgenstern, H. (1982) Epidemiologic Research: Principles and Qualitative Methods. Belmont: Lifetime Learning Publications.Google Scholar
Lane, R., Glazer, W., Hansen, T., Berman, W. & Kramer, S. (1985) Assessment of tardive dyskinesia using the AIMS. Journal of Nervous and Mental Diseases, 173, 15.CrossRefGoogle Scholar
McAndrew, J., Case, Q. & Treffert, D. (1972) Effects of prolonged phenothiazine intake on psychotic and other hospitalized children. Journal of Autism and Childhood Schizophrenia, 2, 7591.CrossRefGoogle ScholarPubMed
Moore, D. C. & Bowers, M. B. (1980) Identification of a subgroup of tardive dyskinesia patients by pharmacologic probes. American Journal of Psychiatry, 137, 12021205.Google ScholarPubMed
Nunnally, J. C. (1978) Psychometric Theory, 2nd edn. New York: McGraw Hill.Google Scholar
Polizos, P., Engelhardt, D. & Hoffman, S. (1973) CNS consequence of psychotropic drug withdrawal in schizophrenic children. Psychopharmacology Bulletin, 9, 3435.Google Scholar
Price, T. R. P. & Levin, R. (1978) The effects of electroconvulsive therapy on tardive dyskinesia. American Journal of Psychiatry, 135, 991993.Google ScholarPubMed
Rosenbaum, A. H., Niven, R. G., Hansen, N. P. & Swanson, D. W. (1977) Tardive dyskinesia: relationship with a primary affective disorder. Diseases of the Nervous System, 38, 423427.Google ScholarPubMed
Rosenbaum, A. H., Maruta, T., Duane, D. D. et al (1980) Tardive dyskinesia in depressed patients: successful therapy with antidepressants and lithium. Psychosomatics, 21, 715719.CrossRefGoogle ScholarPubMed
Rush, M., Diamond, F. & Alpert, M. (1982) Depression as a risk factor in tardive dyskinesia. Biological Psychiatry, 17, 387392.Google ScholarPubMed
Smith, J. M., Kucharski, L. T., Oswald, W. T. & Waterman, L. G. (1979) A systematic investigation of tardive dyskinesia in inpatients. American Journal of Psychiatry, 136, 918922.Google ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773782.CrossRefGoogle ScholarPubMed
Summer, F. & Hersh, S. (1983) Psychiatric chronicity and diagnosis. Schizophrenia Bulletin, 9, 122133.CrossRefGoogle Scholar
Tarsy, D. & Baldessarini, R. (1978) The tardive dyskinesia syndrome. In Clinical Neuropharmacology, Vol. 1 (ed. Klawans, H.). New York: Raven Press.Google Scholar
Trelles, L., Trelles, O., Castenda, C. & Castro, C. (1985) Remission of tardive dyskinesia during mania in a case of manic depressive illness. Revue Neurologique (Paris), 141, 415416.Google Scholar
Wegner, J., Catalano, F., Gibralter, J. & Kane, J. (1985) Schizophrenics with tardive dyskinesia: neuropsychological deficit and familial psychopathology. Archives of General Psychiatry, 42, 860865.CrossRefGoogle Scholar
Yassa, R., Nair, V. & Schwartz, G. (1984) Tardive dyskinesia and the primary psychiatric diagnosis. Psychosomatics, 25, 11351138.CrossRefGoogle ScholarPubMed
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