Skip to main content
SpringerLink
Log in

Tardive Dystonia

Prevatence, risk factors, and comparison with tardive dyskinesia in a population of 200 acute psychiatric inpatients

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

In a population of 200 consecutive inpatients with a history of at least 3 months' total cumulative neuroleptic exposure, the prevalence of tardive dystonia (TDt) was 4%, higher than previously reported. The prevalence of tardive dyskinesia (TDk) was 22%. Patients with TDt did not differ in demographic or clinical variables from nondyskinetic patients. In comparison with patients with TDk, patients with TDt were significantly younger, had a more severe movement disorder, and had received neuroleptics for the first time fewer years before. Patients with TDk were significantly older than patients without tardive disorders, both when they were examined and when they had started their first neuroleptic treatment. Furthermore, they had started their first neuroleptic treatment more years before. These results support the distinction between TDt and TDk, and suggest that the previously reported prevalence of TDt might have been underestimated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adams RD, Victor M (1993) Principles of neurology, 5th edn. McGraw-Hill, New York, pp 71–72

    Google Scholar 

  2. Adityanjee, Jayaswal SK, Chan TM, Subramaniam M (1990) ECT for tardive dystonia. Br J Psychiatry 156:433–435

    Google Scholar 

  3. Altamura AC, Cavallaro R, Regazzetti MG (1990) Prevalence and risk factors for tardive dyskinesia: a study in an Italian population of chronic schizophrenics. Eur Arch Psychiatry Clin Neurosci 240:9–12

    Google Scholar 

  4. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (DSM-III-R) 3rd edn, revised. American Psychiatric Press, Washington, DC

    Google Scholar 

  5. Angermeyer MC, Kuhn L, Goldstein JM (1990) Gender and the course of schizophrenia: differences in treated outcome. Schizophr Bull 16:293–307

    Google Scholar 

  6. Baldessarini RJ (1985) Chemotherapy in psychiatry: principles and practice. Harvard University Press, Cambridge, Mass

    Google Scholar 

  7. Bech P, Kastrup M, Rafaelsen OJ (1986) Minicompendium of rating scales. Acta Psychiatr Scand 73 (Suppl 326)

  8. Brown KW, White T (1991) The psychological consequences of tardive dyskinesia. Br J Psychiatry 159:399–403

    Google Scholar 

  9. Burke RE, Fahn S, Jankovic J et al. (1987) Tardive dystonia: late onset and persistent dystonia caused by antipsychotic drugs. Neurology 32:1335–1346

    Google Scholar 

  10. Burke RE, Kang UJ (1988) Tardive dystonia: clinical aspects and treatment. In: Fahn S et al (eds) Advances in neurology. Raven Press, New York, 49:199–210

    Google Scholar 

  11. Cavallaro R, Regazzetti MG, Mundo E, Brancato V, Smeraldi E (1993) Tardive dyskinesia outcomes: clinical and pharmacologic correlates of remission and persistence. Neuropsychopharmacology 8:233–239

    Google Scholar 

  12. Casey DE (1987) Tardive dyskinesia. In: Meltzer HY (ed) Psychopharmacology: the third generation of progress. Raven Press, New York

    Google Scholar 

  13. Chiu H, Shum P, Lau J, Lam L, Lee S (1992) Prevalence of tardive dyskinesia, tardive dystonia, and respiratory dyskinesia among Chinese psychiatric patients in Hong Kong. Am J Psychiatry 149:1081–1085

    Google Scholar 

  14. Chouinard G, Annable L, Mercier P, Ross-Chouinard A (1986) A five-year follow-up study of tardive dyskinesia. Psychopharmacol Bull 22:259–263

    Google Scholar 

  15. Davis EJB, Borde M, Sharma LN (1992) Tardive dyskinesia and type II schizophrenia. Br J Psychiatry 160:253–256

    Google Scholar 

  16. Fahn S (1987) Drug treatment of hyperkinetic movement disorders. Semin Neurol 7:192–208

    Google Scholar 

  17. Famuyiwa OO, Eccleston D, Donaldson AA, Garside RF (1979) Tardive dyskinesia and dementia. Br J Psychiatry 135:500–504

    Google Scholar 

  18. Flor-Henry P (1990) Influence of gender in schizophrenia as related to other psychopathological syndromes. Schizophr Bull 16:211–227

    Google Scholar 

  19. Friedman JH, Kuraski LT, Wagner RI (1987) Tardive dystonia in a psychiatric hospital. J Neurol Neurosurg Psychiatry 50:801–803

    Google Scholar 

  20. Ganzini L, Heintz RT, Hoffman WF, Casey DE (1991) The preyalence of tardive dyskinesia in neuroleptic-treated diabetics. Arch Gen Psychiatry 48:259–263

    Google Scholar 

  21. Gelenberg AJ (1987) Treating extrapyramidal reactions: some current issues. J Clin Psychiatry (Suppl 9):24–27

    Google Scholar 

  22. Gerlach J, Casey DE (1988) Tardive dyskinesia. Acta Psychiatr Scand 77:369–378

    Google Scholar 

  23. Gershanik OS (1993) Drug-induced movement disorders. Curr Opin Neurol Neurosurg 6:369–376

    Google Scholar 

  24. Gimenez-Roldan S, Mateo D, Bartolome P (1985) Tardive dystonia and severe tardive dyskinesia. Acta Psychiatr Scand 71:488–494

    Google Scholar 

  25. Goldman MB, Luchins DJ (1984) Intermittent neuroleptic therapy and tardive dyskinesia: a literature review. Hosp Comm Psychiatry 35:1215–1219

    Google Scholar 

  26. Granacher RP (1981) Differential diagnosis of tardive dyskinesia: an overview. Am J Psychiatry 138:1288–1297

    Google Scholar 

  27. Harris MJ, Jeste DV (1988) Late-onset schizophrenia: an overview. Schizophr Bull 14:39–55

    Google Scholar 

  28. Jeste DV, Wyatt RJ (1982) Understanding and treating dyskinesia. The Guildford Press, New York

    Google Scholar 

  29. Kane JM (1987) Treatment of schizophrenia. Schizophr Bull 13:133–156

    Google Scholar 

  30. Kane JM, Struve FA, Weinhold P (1980) Strategy for the study of patients at high risk for tardive dyskinesia. Am J Psychiatry 137:1265–1267

    Google Scholar 

  31. Kane JM, Woener M, Lieberman J (1985) Tardive dyskinesia: prevalence, incidence and risk factors. In: Casey DE, Chase T, Christensen AV, Gerlach J (eds) Dyskinesia research and treatment. Psychopharmacology (Suppl 2). Springer, Berlin Heidelberg New York, pp 72–78

    Google Scholar 

  32. Kane JM, Woerner M, Borenstein M, Wegner J, Lieberman J (1986) Integrating incidence and prevalence of tardive dyskinesia. Psychopharmacol Bull 22:254–258

    Google Scholar 

  33. Kang UJ, Burke RE, Fahn S (1986) Natural history and treatment of tardive dystonia. Mov Disord 1:193–208

    Google Scholar 

  34. Kaplan Z, Benjamin J, Zohar J (1991) Remission of tardive dystonia with ECT. Convulsive Ther 7:280–283

    Google Scholar 

  35. Keegan DL, Rajput AH (1973) Drug-induced dystonia tarda: treatment with L-dopa. Dis Nerv Syst 38:167–169

    Google Scholar 

  36. Kissling W (1992) Ideal and reality of neuroleptic relapse prevention. Br J Psychiatry 161 (Suppl 18):133–139

    Google Scholar 

  37. Korczyn AD, Inzelberg R (1993) Dystonia. Curr Opin Neurol Neurosurg 6:350–357

    Google Scholar 

  38. Kraepelin EL (1919) Textbook of Psychiatry, vol 3: dementia praecox. McMillan, London

    Google Scholar 

  39. Lamberti JS, Bellnier T (1993) Clozapine and tardive dystonia. J Nerv Ment Dis 181:137–138

    Google Scholar 

  40. Lewine RRJ (1981) Sex differences in schizophrenia: timing or subtypes. Psychol Bull 90:432–444

    Google Scholar 

  41. Lewine RRJ, Burbach D, Meltzer HY (1984) The effect of diagnostic criteria on the proportion of male to female schizophrenics. Am J Psychiatry 141:84–87

    Google Scholar 

  42. Lieberman JA, Alvir J, Mukherjee S, Kane JM (1989) Treatment of tardive dyskinesia with bromocriptine. Arch Gen Psychiatry 46:908–913

    Google Scholar 

  43. Lieberman JA, Saltz BL, Johns CA, Pollack S, Borenstein M, Kane J (1991) The effects of clozapine on tardive dyskinesia. Br J Psychiatry 158:503–510

    Google Scholar 

  44. Luchins D, Goldman M (1985) High dose bromocriptine in a case of tardive dystonia. Biol Psychiatry 20:179–181

    Google Scholar 

  45. Marsden CD, Quinn NP (1990) The dystonias. Br Med J 300:139–144

    Google Scholar 

  46. McClelland HA, Metcalfe AV, Kerr TA et al (1991) Facial dyskinesia: a 16-year follow-up study. Br J Psychiatry 158:691–696

    Google Scholar 

  47. Muscettola G, Pampallona S, Barbato G et al (1989) Tardive dyskinesia in Italy: preliminary findings. Arch Gen Psychiatry 46:754–755

    Google Scholar 

  48. NIHM, Psychopharmacology Research Branch (1986) Psychopharmacol Bull 24:781–782

    Google Scholar 

  49. Overall JE, Gorhan DR (1962) The Brief Psychiatric Rating Scale. Psychol Rep 10:799–812

    Google Scholar 

  50. Owens DGC (1990) Dystonia—a potential psychiatric pitfall. Br J Psychiatry 156:620–634

    Google Scholar 

  51. Ozelius LJ, Kramer PL, De Leon D, Rish N, Bressman SB, Schuback DE, Brin ME, Kwiatkowski DJ, Burke RE, Gusella JF, Fahn S, Breakfield XO (1992) Strong allelic association between the Torsion dystonia gene (DYT1) and loci on chromosome 9q34 in Ashkenazi Jews. Am J Human Genet 50:619–628

    Google Scholar 

  52. Raja M, Altavista MC, Maisto G (1994) Severe tardive lingual dystonia. In: Focus on dystonia. A Satellite Meeting of the 11th Parkinson's Disease Symposium, Rome, March 25, 1994. Abstract book P04, p 34

  53. Roller WC (1988) Tardive dystonia: diagnosis and treatment. In: Wolf ME, Mosnaim AD (eds) Tardive dyskinesia: biological mechanisms and clinical aspects. American Psychiatric Press, Washington, DC

    Google Scholar 

  54. Rush M, Diamond F, Alpert M (1982) Depression as a risk factor in tardive dyskinesia. Biol Psychiatry 17:387–392

    Google Scholar 

  55. Sachdev P (1991) The prevalence of tardive dystonia in patients with chronic schizophrenia (letter). Aust N Z J Psychiatry 25:446–448

    Google Scholar 

  56. Sachdev P (1993) Risk factors for tardive dystonia: a case-control comparison with tardive dyskinesia. Acta Psychiatr Scand 88:98–103

    Google Scholar 

  57. Schooler NR, Kane JM (1982) Research diagnoses for tardive dyskinesia. Arch Gen Psychiatry 39:486–487

    Google Scholar 

  58. Thaker GK, Nguyen JA, Strauss ME, Jacobson R, Kaup BA, Tamminga CA (1990) Clonazepam treatment of tardive dyskinesia: a practical GABA mimetic strategy. Am J Psychiatry 147:445–451

    Google Scholar 

  59. Waddington JL, Youssef HA (1986) An unusual cluster of tardive dyskinesia in schizophrenia: association with cognitive dysfunction and negative symptoms. Am J Psychiatry 143:1162–1165

    Google Scholar 

  60. Waddington JL, Youssef HA, Dolphim C, Kinsella A (1987) Cognitive dysfunction negative symptoms, and tardive dyskinesia in schizophrenia. Arch Gen Psychiatry 44:907–912

    Google Scholar 

  61. Waddington JL, Youssef HA (1988) The expression of schizophrenia, affective disorder and vulnerability to tardive dyskinesia in an extensive pedigree. Br J Psychiatry 153:376–381

    Google Scholar 

  62. Wahl OF, Hunter J (1992) Are gender effects being neglected in schizophrenia research? Schizophr Bull 18:313–317

    Google Scholar 

  63. Westermeyer JF, Harrow M (1984) Prognosis and outcome using broad (DSM-II) and narrow (DSM-III) concepts of schizophrenia. Schizophr Bull 10:624:637

    Google Scholar 

  64. Wojcik JD, Falk WE, Fink JS et al (1991) A review of 32 cases of tardive dystonia. Am J Psychiatry 148:1055–1059

    Google Scholar 

  65. Wolf ME, Mosnaim AD (1984) Identifying subtypes of tardive dyskinesia. Hosp Community Psychiatry 35:828–830

    Google Scholar 

  66. Yassa R, Nair V, Schwartz G (1984) Tardive dyskinesia: a two-year follow-up study. Psychosomatics 25:852–855

    Google Scholar 

  67. Yassa R, Nair V, Dimitry R (1986) Prevalence of tardive dystonia. Acta Psychiatry Scand 73:629–633

    Google Scholar 

  68. Yassa R, Nair V, Schwartz G (1986) Early versus late onset psychosis and tardive dyskinesia. Biol Psychiatry 21:1291–1297

    Google Scholar 

  69. Yassa R, Nair V, Iskandar H (1989) A comparison of severe tardive dystonia and severe tardive dyskinesia. Acta Psychiatr Scand 80:155–159

    Google Scholar 

  70. Yassa R, Nair NPV, Iskandar H, Schwartz G (1990) Factors in the development of severe forms of tardive dyskinesia. Am J Psychiatry 147:1156–1163

    Google Scholar 

  71. Yassa W, Jeste DV (1992) Gender differences in tardive dyskinesia: a critical review of the literature. Schizophr Bull 18:701–715

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Servizio psichiatrico di diagnosi e cura, Ospedale “Santo Spirito”, Dipartimento di salute mentale USL RM E, Rome, Italy

    Michele Raja

Authors
  1. Michele Raja
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Raja, M. Tardive Dystonia. Eur Arch Psychiatry Clin Nuerosci 245, 145–151 (1995). https://doi.org/10.1007/BF02193087

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02193087

Key words

Search

Navigation