Tardive dyskinesia in long term hospitalized patients with schizophreniaObjective: Tardive dyskinesia (TD) is a group of delayed-onset iatrogenic movement disorders caused by dopamine receptor-blocking agents. TD prevalence is estimated as 20-50% of all patients treated with neuroleptics. This study aimed to investigate the prevalence rate of TD in long-term hospitalized patients with schizophrenia.
Method:We recorded age, gender, duration and type (first/second generation or mixed) of medication both at the time of interview and over preceding years. Dyskinesia was assessed by using the Abnormal Involuntary Movements Scale (AIMS). We also used the Simpson-Angus Scale for tardive parkinsonism.Akathisia was measured using the Barnes Akathisia Rating Scale (BARS).Results: Mean duration of the longest used antipsychotic was 206.63 months. Probable TD was found in 18 (22.5%) of patients. None of the patients had tardive akathisia. Relation between type of the longest used treatment and prevalence of TD was not statistically significant. Relationship between type of ongoing treatment and prevalence of TD was not determined statistically significant either. There was a statistically significant relationship between the mean age and TD.Discussion: Despite very long duration of antipsychotic use, 22.5% rate of prevalence is still lower than expected. This can be explained that these patients are under direct and close follow-up of healthcare providers and in hospital conditions, so that risky conditions can be intervened rapidly. Another noteworthy finding of our study is that there is no statistically significant difference betwen first and second generation antipsychotic use and TD prevalence. Sonuç: Uzun süreli ilaç kullanımı olan bir grupta %22.5 oranı, yine de, beklenenden düşüktür. Hastaların hastane ortamında ve sağlık çalışanları gözetiminde doğrudan ve yakın izlemde olmaları ve risk oluşturabilecek durumlara erken müdahale edilmesi bu durum için bir açıklama olabilir. 1. ve 2. kuşak antipsikotik kullanımıyla ile TD yaygınlığı arasında çalışmamızda istatistik olarak anlamlı fark bulunmamısı da bir diğer önemli bulgudur.
Clinical characteristics of euthymic bipolar disorder patients comorbid with alcohol and drug use disorders and psychometric properties of the assessment tools Objective: The primary objective of this study was to identify the frequency of alcohol and drug use disorder -abuse or dependence-(ADUD) in bipolar disorder patients who were followed in a specialized mood disorders unit and to investigate the clinical characteristics of the sample. Secondary aim of the study was to evaluate the psychometric properties of the scales related with alcohol and drug use disorder among bipolar patients in remission.
Methods: Alcohol Use Disorders Identification Test (AUDIT), Michigan Alcoholism Screening Test (MAST), Drug Use Disorders Identification Test (DUDIT), and Drug Abuse Screening Test (DAST-10) were applied to 292 bipolar disorder patients in the euthymic state, diagnosed by using mood disorder and alcohol/drug use disorder modules of the Structured Clinical Interview Form for DSM-IV Axis I Disorders (SCID-I) and monitored in our Mood Disorders Center.Results: In our sample, frequency of bipolar disorder patients with ADUD was 6.16% (18/292). 15 of 18 patients with ADUD were men and 3 were women. ADUD in men (12.00%) was higher than in women (1.79%), and this difference was statistically significant (p<0.001). Alcohol use disorder frequency was detected as 5.14% in general (15/292), 9.60% in men (12/125) and 1.79% in women (3/167). The frequency of drug use disorder was found as 4.11% in general (12/292), 8.00% in men (10/125) and 1.19% in women (2/167). Proportion of depressive, manic, hypomanic, and mixed episodes did not differ between patients with ADUD and those without ADUD, whereas the proportion of total episodes was higher in patients with ADUD and difference was statistically significant (p=0.016).Conclusions: Frequency of bipolar disorder patients comorbid with ADUD followed up in our center was found to be lower than those reported in the literature.
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