A comparison of purposeless movements in psychiatric patients treated with antipsychotic drugs, and normal individuals.

Abstract

SUMMARY Oro-facial dyskinesia and purposeless trunk and limb movements were assessed, using a standard videotape rating technique, in 182 psychiatric patients receiving antipsychotic medication, in a second sample of 43 elderly psychiatric patients also receiving antipsychotic drugs, and 85 normal, drug-naive subjects. In both the first patient sample and the group of normal subjects, oro-facial dyskinesia was more common over 50 years of age. Statistical analysis of the data suggested that drug-induced oro-facial dyskinesia has a characteristic pattern of movement distribution significantly different from that of idiopathic oro-facial dyskinesia. The videotapes of the first patient sample and the normal subjects were viewed by a neurologist who assessed and categorised all movements. Purposeless trunk and limb movements were classified as either normal or abnormal. Normal purposeless movements were significantly more common in the drug-naive subjects. The presence of abnormal movements such as choreiform movements, dystonias and stereotypies and mannerisms was limited, almost exclusively, to the patients.Tardive dyskinesia is a movement disorder induced by antipsychotic drugs. It is characterised by abnormal movements affecting the face, principally the tongue, lips and jaw, producing a typical picture referred to as the bucco-linguo-masticatory syndrome.' Choreiform movements of the limbs and axial hyperkinesias are usually included within the syndrome description. However, there are a number of problems inherent in trying to assess tardive dyskinesia quantitatively and qualitatively.23 The operational diagnostic criteria used between clinical research groups vary considerably and this complicates the interpretation of results. There are also discrepancies between the rating scales used, not only regarding the number and definition of movement categories included but also their relative importance, as indicated by the scoring systems. The precise nature and distribution of abnormal movements are seldom attended to by investigators. Rather, the individual dyskinetic phenomena tend to be obscured by the use of arbitrary global categones.Tardive dyskinesia is not specific to schizophrenic patients and has been reported in non-psychotic

Prevalence of spontaneous oral dyskinesia in the elderly: A reappraisal

“…Our study also provided clues that the oral stereotypies observed in SOD may often be distinguished from TD. In SOD, the movement disorder is generally mild in intensity2, 14, 17 and our own cases were characterized by predominant but not exclusive labial or jaw movements. However, predominance of tongue and lips movements2 and lower ratings for lips and jaw movements17 have been reported in cases diagnosed as SOD compared to TD cases.…”

“…In SOD, the movement disorder is generally mild in intensity2, 14, 17 and our own cases were characterized by predominant but not exclusive labial or jaw movements. However, predominance of tongue and lips movements2 and lower ratings for lips and jaw movements17 have been reported in cases diagnosed as SOD compared to TD cases. In contrast to TD, complex and severe tongue movements, dystonic jaw opening, and extension to facial, cervical, or limb musculature were never observed in our SOD group and should call for alternative diagnoses.…”

Variations of rest – activity rhythm and sleep – wake in schizophrenic patients versus healthy subjects: An actigraphic comparative study

“…Studies show that motor activity is decreased by antipsychotics even at lower doses than those causing extrapyramidal side-effects (EPS) (Ahlenius & Hillegaart 1986;Kiang et al 2003;McLean et al 1978). Normal purposeless movements, such as restlessness, fidgeting and shifting posture were found to be less frequent in patients receiving antipsychotics compared to normal control subjects (Barnes et al 1983).…”

Dyskinesia and Neuroleptic Exposure in Elderly Psychiatric Inpatients

“…Journal of Geriatric Psychiatry a n d Neurology / Vol 5. I July-September 1992 at University of Manitoba Libraries on June 25, 2015 jgp.sagepub.com Downloaded from…”