Am J Psychiatry 1992; 149:1385-1389
Copyright © 1992 by American Psychiatric Association
The influence of topography on the cognitive and psychopathological effects of tardive dyskinesia
KW Brown and T White
Royal Edinburgh Hospital, Scotland, UK.
OBJECTIVE: The purpose of the study was to investigate the influence of the
topography of dyskinetic movements on their effect on cognitive impairment
and negative symptoms. METHOD: Eighty-four inpatients who satisfied
DSM-III-R criteria for schizophrenia were rated for tardive dyskinesia,
akathisia, and drug-induced parkinsonism, as well as negative symptoms,
with the Scale for the Assessment of Negative Symptoms and for cognitive
state with the Mini-Mental State examination. The subjects were then
divided into those without tardive dyskinesia (N = 45), those with
orofacial dyskinesia (N = 19), and those with limb-truncal dyskinesia (N =
20). Differences among the groups were assessed with multiple analysis of
covariance (MANCOVA), with age, akathisia, and drug-induced parkinsonism
ratings as the covariates. Post hoc Spjotvoll and Stoline tests were then
undertaken. RESULTS: MANCOVA revealed a significant difference among the
groups. Post hoc tests showed that the group with limb-truncal dyskinesia
had significantly lower scores on the Mini-Mental State Examination and
higher scores on the Scale for the Assessment of Negative Symptoms. The
group with orofacial dyskinesia was significantly different from the
nondyskinetic group only on the total score for the Scale for the
Assessment of Negative Symptoms and the attention subscale. There were no
significant differences between the dyskinetic groups. CONCLUSIONS: After
correction for the important confounding variables of age, akathisia, and
drug-induced parkinsonism scores, those with limb- truncal and, to a lesser
degree, orofacial dyskinesia differed significantly from nondyskinetic
comparison subjects in ratings of cognitive impairment and negative
symptoms.
