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Tardive Dyskinesia and Positive and Negative Symptoms of Schizophrenia

A Study Using Instrumental Measures

Published online by Cambridge University Press:  02 January 2018

Owen Yuen
Affiliation:
Department of Psychiatry, University of Calgary, Alberta, Canada
Michael P. Caligiuri*
Affiliation:
University of California at San Diego, California
Richard Williams
Affiliation:
Department of Psychiatry, University of Calgary, Alberta, Canada
Ruth A. Dickson
Affiliation:
Department of Psychiatry, University of Calgary, Alberta, Canada
*
Dr Michael P. Caligiuri, Motor Function Laboratory, Department of Psychiatry (0603), University of California La Jolla, California 92093-0603. Fax: 619-552-7404; e-mail: [email protected]

Abstract

Background

Controversy surrounds the relationship between tardive dyskinesia (TD) and symptoms of schizophrenia. While some studies reported that negative symptoms of schizophrenia may be a risk factor for TD, others reported a relationship between TD and positive symptoms.

Method

Eighty-four patients were studied, of whom 47 met criteria for TD. Clinical and instrumental procedures were used to increase the sensitivity of our assessments of the presence and severity of TD. Stepwise logistic and linear regression procedures were used to identify demographic variables, psychopathology, and motor parameters associated with the presence and severity of TD.

Results

A 3-factor model consisting of age, clinical tremor, and negative symptoms explained 25% of the variance in clinical TD severity. A 6-factor model consisting of female gender, instrumental and clinical measures of parkinsonism, positive, and negative symptoms explained 49% of the variance in severity of instrumentally derived dyskinesia.

Conclusions

These results suggest that the presence of TD may be associated with positive symptoms; that the severity of TD may be related to negative symptoms; and that the relationship between negative symptoms and TD severity may be influenced by the presence of parkinsonism.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1992) Tardive Dyskinesia: A Task Force Report of the American Psychiatric Association. Washington, DC: APA.Google Scholar
Bartzokis, G., Hill, M. A. & Altshuler, L. (1989) Tardive dyskinesia in schizophrenia patients; correlation with negative symptoms. Psychiatry Research, 28, 145151 CrossRefGoogle ScholarPubMed
Brown, K. W. & White, T. (1991) The association among negative symptoms, movement disorders, and frontal lobe psychological deficits in schizophrenic patients. Biological Psychiatry, 30, 11821190.CrossRefGoogle ScholarPubMed
Caligiuri, M. P. (1994) Portable device for quantifying parkinsonian rigidity. Movement Disorders, 9, 5763.CrossRefGoogle Scholar
Caligiuri, M. P., Lohr, J. B., Brach, H. S., et al (1991) Clinical and instrumental assessment of neuroleptic-induced Parkinsonism in patients with tardive dyskinesia. Biological Psychiatry, 29, 139148.Google Scholar
Caligiuri, M. P., Lohr, J. B., (1992) Worsening of postural tremor in patients with levodopa-induced dyskinesia: A quantitative analysis. Clinical Neuropharmacology, 16, 244250.CrossRefGoogle Scholar
Caligiuri, M. P., Lohr, J. B., Vaughan, W. R. M., et al (1995) Fluctuation of tardive dyskinesia. Biological Psychiatry, 38, 336339.CrossRefGoogle ScholarPubMed
Casey, D. E. (1993) Neuroleptic-induced acute extrapyramidal syndromes and tardive dyskinesia. Psychiatric Clinics of North America, 16, 589610.Google Scholar
Csernasky, J. G., Murphy, G. M. & Faustman, W. O. (1991) Limbic/mesolimbic connections and the pathogenesis of schizophrenia. Biological Psychiatry, 30, 383400.CrossRefGoogle Scholar
Davis, K. D., Kahn, R. S., Ko, G., et al (1991) Dopamine in schizophrenia: A review and reconceptualization. American Journal of Psychiatry, 148, 14741486.Google ScholarPubMed
Davis, E. J. B., Borde, M. & Sharma, L. N. (1992) Tardive dyskinesia and type II schizophrenia. British Journal of Psychiatry, 160, 253256.CrossRefGoogle ScholarPubMed
Feltner, D. E. & Hertzman, M. (1993) Progress in the treatment of tardive dyskinesia: Theory and practice. Hospital and Community Psychiatry, 44, 35–34.Google ScholarPubMed
Fenton, W. S., Wyatt, R. J. & McGlashan, T. H. (1994) Risk factors for spontaneous dyskinesia in schizophrenia. Archives of General Psychiatry, 51, 643650.Google Scholar
Iager, A. C., Kirch, D. G., Jeste, D. V., et al (1986) Defect symptoms and abnormal involuntary movement in schizophrenia. Biological Psychiatry, 21, 751775.Google Scholar
Jeste, D. V., Caugiuri, M. P., Paulsen, J., et al (1995) Risk of tardive dyskinesia in older patients: A longitudinal study of 266 patients. Archives of General Psychiatry, 52, 756765.Google Scholar
Kay, S. R., Fiszbein, A. & Opler, L. A. (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261276.CrossRefGoogle ScholarPubMed
Liddle, P. F., Barnes, T. R., Speller, J., et al (1993) Negative symptoms as a risk factor for tardive dyskinesia in schizophrenia. British Journal of Psychiatry, 163, 776780.Google Scholar
McGlashan, T. H. & Fenton, W. S. (1992) The positive-negative distinction in schizophrenia: review of natural history validators. Archives of General Psychiatry, 49, 6373.CrossRefGoogle ScholarPubMed
National Institute of Mental Health (1976) Abnormal Involuntary Movement Scale. In Early Clinical Drug Evaluation Unit Assessment Manual, (ed. Guy, W.), pp. 534537. Rockville, MD: US Department of Health, Education and Welfare.Google Scholar
Sandyk, R. & Kay, S. R. (1990) The relationship of negative schizophrenia to parkinsonism. International Journal of Neuroscience, 55, 159.CrossRefGoogle ScholarPubMed
Schooler, N. R. & Kane, J. M. (1982) Research diagnoses for tardive dyskinesia. Archives of General Psychiatry, 39, 486487.Google Scholar
Simpson, G. N. & Angus, J. W. S. (1970) A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica, (Suppl) 212, 1119.CrossRefGoogle ScholarPubMed
Waddington, J. L. (1989) Schizophrenia, affective psychosis, and other disorders treated with neuroleptic drugs: the enigma of tardive dyskinesia, its neurobiological determinants, and the conflict of paradigms. International Review of Neurobiology, 31, 297353.CrossRefGoogle Scholar
Waddington, J. L. (1995) Psychopathological and cognitive correlates of tardive dyskinesia in schizophrenia and other disorders treated with neuroleptic drugs. In Behavioral Neurology of Movement Disorders (eds Weiner, W. J. & Lang, A. E.), pp. 211229. New York: Raven Press.Google Scholar
Waddington, J. L., Youssef, H. A., Molloy, A. G., et al (1985) Association of intellectual impairment, negative symptoms, and aging with tardive dyskinesia: clinical and animal studies. Journal of Clinical Psychiatry, 46, 2933.Google ScholarPubMed
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