Spontaneous Movement Disorders in Psychiatric Patients

Richard, Irene Hegeman; O’Brien, Christopher F.; Kurlan, Roger

doi:10.1002/9780470753217.ch3

Cited by 2 publications

(2 citation statements)

References 94 publications

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“…An estimated 20 to 25% of PD patients in specialty care are on an antidepressant at any given time, 5,6 most commonly a selective serotonin reuptake inhibitor (SSRI). 6 However, it still appears that depression in PD (dPD) is under recognized and under treated.…”

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confidence: 99%

Attitudes Regarding the Etiology and Treatment of Depression in Parkinson's Disease: A Qualitative Study

Oehlberg

Barg

Brown

et al. 2008

J Geriatr Psychiatry Neurol

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Depression in Parkinson's disease (dPD) remains under recognized and under treated. As patients' beliefs may impact the reporting and treatment of depression, this study assessed the opinions of 38 dPD patients, approximately half with a self-reported poor response to antidepressant treatment, regarding the etiology and treatment of their depression using a semi-structured, audio-taped, qualitative interview. About half of the participants listed PD itself as a primary cause for their depressive symptoms, with most in this group citing psychosocial factors rather than PD-related neurobiological factors. Antidepressant therapy, psychotherapy, and self-initiated approaches were noted as preferred treatments for dPD. Many had concerns about antidepressant therapy, listing side-effects and medication dependency most frequently. About half raised concerns about psychotherapy with trust/discomfort, stigma, and transportation issues most frequently mentioned. This preliminary study suggests that many PD patients with clinically significant depressive symptoms attribute their depression to psychosocial factors and endorse nonpharmacologic treatment approaches.

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confidence: 99%

Attitudes Regarding the Etiology and Treatment of Depression in Parkinson's Disease: A Qualitative Study

Oehlberg

Barg

Brown

et al. 2008

J Geriatr Psychiatry Neurol

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“…Psychomotor disorders are a core symptom dimension in schizophrenia and were recognized decades before antipsychotics were introduced 3,67–71. While TD may present in a variety of forms simulating classical neurological movement disorders (eg, chorea or dystonia), spontaneous movements found among psychiatric patients include a wide range of hyperkinetic (eg, mannerisms, stereotypies, compulsions) or hypokinetic behaviors (eg, psychomotor retardation, mutism, catalepsy) 72. Clinicians and supporting staff may be misled by the fact that neurological movement disorders including TD often fluctuate with anxiety, arousal, and distraction, disappear during sleep, and can be suppressed by voluntary exertion, which often leads to misinterpreting drug-induced movement disorders as intentional “acting out” or attention-seeking behaviors.…”

Section: Diagnosis Of Tdmentioning

confidence: 99%

<p>Overcoming barriers to effective management of tardive dyskinesia</p>

Caroff¹

2019

NDT

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Tardive dyskinesia (TD) is a heterogeneous syndrome of involuntary hyperkinetic movements that is often persistent and occurs belatedly during treatment with antipsychotics. Recent approval of two dopamine-depleting analogs of tetrabenazine based on randomized controlled trials offers an evidence-based therapeutic approach to TD for the first time. These agents are optimally used within the context of a comprehensive approach to patient management that includes a practical screening and monitoring program, sensitive and specific criteria for the diagnosis of TD, awareness of the severity and impact of the disorder, informed discussions with patients and caregivers, and a rational basis for prescribing decisions about continued antipsychotic and adjunctive agents. Areas of limited or inconclusive data, bias and misunderstandings about key aspects, and neglect of training about TD in recent years contribute to barriers in providing effective care and promoting patient safety.

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Spontaneous Movement Disorders in Psychiatric Patients

Cited by 2 publications

References 94 publications

Attitudes Regarding the Etiology and Treatment of Depression in Parkinson's Disease: A Qualitative Study

Attitudes Regarding the Etiology and Treatment of Depression in Parkinson's Disease: A Qualitative Study

<p>Overcoming barriers to effective management of tardive dyskinesia</p>

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