The life expectancy of schizophrenic patients with tardive dyskinesia

Inada, Toshiya; Koshiishi, Mika; Ohnishi, K.; Yagi, Gohei

doi:10.1002/hup.470070404

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Previous studies have reported inconsistent results. Four of eleven studies reported an association between TD and mortality, 12,[15][16][17] two reported a trend, 42,43 and five no association. [18][19][20][21]43 In 2000, a meta-analysis by Ballesteros et al consisting of seven studies demonstrated a significant overall OR of 1.4.…”

Section: Discussionmentioning

confidence: 99%

“…Four of eleven studies reported an association between TD and mortality, 12,[15][16][17] two reported a trend, 42,43 and five no association. [18][19][20][21]43 In 2000, a meta-analysis by Ballesteros et al consisting of seven studies demonstrated a significant overall OR of 1.4. 11 However, some of the included studies suffered from methodological problems, such as fewer than five years follow-up 3,4,6,8 and no control for known confounders such as antipsychotic dose.…”

Section: Discussionmentioning

confidence: 99%

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Movement Disorders and Mortality in Severely Mentally Ill Patients: The Curacao Extrapyramidal Syndromes Study XIV

Willems,

Mentzel,

Bakker

et al. 2022

Schizophrenia Bulletin

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Background and Hypothesis There is a substantial gap in life expectancy between patients with severe mental illness (SMI) and the general population and it is important to understand which factors contribute to this difference. Research suggests an association between tardive dyskinesia (TD) and mortality; however, results are inconclusive. In addition, studies investigating associations between parkinsonism or akathisia and mortality are rare. We hypothesized that TD would be a risk factor for mortality in patients with SMI. Study Design We studied a cohort of 157 patients diagnosed predominantly with schizophrenia on the former Netherlands Antilles. TD, parkinsonism, and akathisia were assessed with rating scales on eight occasions over a period of 18 years. Twenty-four years after baseline, survival status and if applicable date of death were determined. Associations between movement disorders and survival were analyzed using Cox regression. Sex, age, antipsychotics, antidepressants and benzodiazepines at each measurement occasion were tested as covariates. Study Results Parkinsonism was a significant risk factor with an HR of 1.02 per point on the motor subscale of the Unified Parkinson’s Disease Rating Scale (range 0–56). TD and akathisia were not significantly associated with mortality. Conclusions Parkinsonism may be an important risk factor for mortality in SMI patients. This finding calls for more follow-up and intervention studies to confirm this finding and to explore whether treatment or prevention of parkinsonism can reduce excess mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Movement Disorders and Mortality in Severely Mentally Ill Patients: The Curacao Extrapyramidal Syndromes Study XIV

Willems,

Mentzel,

Bakker

et al. 2022

Schizophrenia Bulletin

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Tardive Dyskinesia Associated With Higher Mortality in Psychiatric Patients: Results of a Meta-Analysis of Seven Independent Studies

Ballesteros¹,

González-Pinto²,

Bulbena³

2000

Journal of Clinical Psychopharmacology

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This article reports a meta-analysis of seven independent studies on the association of tardive dyskinesia with all-cause mortality in psychiatric patients. Most of the studies included provide either small sample sizes or follow-up periods too short to reach a substantive conclusion on their own. In the meta-analysis, the overall odds ratio (OR) was significant when calculated either by the fixed-effects model (OR = 1.4, 95% confidence interval [CI] = 1.2-1.7, p < 0.005) or the random-effects model (OR = 1.4, 95% CI = 1.1-1.8, p < 0.005). There was no overall heterogeneity (Q test = 8.1, df = 7,p = 0.32). The overall estimate changed within study designs (OR = 1.4,p = 0.002 in three prospective controlled studies; OR = 2.2, p = 0.02 in two prospective uncontrolled studies; and OR = 0.9, p = 0.80 in two retrospective controlled studies). It was modified upward when the two most influential studies (one prospective and one retrospective) were removed from the overview (OR = 2.2, 95% CI = 1.4-3.5,p = 0.001; Q test = 0.81, df = 4,p = 0.94). The conclusion of the meta-analysis was that tardive dyskinesia must be considered a weak risk factor in terms of mortality. It remains to be elucidated whether it is a risk factor on its own or just a surrogate for any unknown organic liability.

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Mortality Rates Among Patients With Schizophrenia and Tardive Dyskinesia

Chong¹,

Tay²,

Subramaniam³

et al. 2009

Journal of Clinical Psychopharmacology

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Tardive dyskinesia (TD) is a severe and potentially irreversible movement, and previous studies have suggested increased mortality among patients with TD, but most of these studies are limited by small sample sizes and short periods of follow-up. This study examined the mortality rate of a cohort of 608 Asian patients with schizophrenia during a 6-year period and used survival analyses on time from case ascertainment to outcome (death). Data on the survival status were collected and compared between those with and without TD, and cross-tabulation was performed to show the correlation between survival and mortality rates among patients with and without TD.Seventy-two patients died, 39 (54.2%) of whom had TD previously. Of the 536 surviving cases, 239 (44.6%) have TD. The mortality rates between those with TD and those without TD were statistically significant (hazard ratio, 2.62; 95% confidence interval, 1.58-4.33; P = 0.0006).The mortality rate was dependent on age; nevertheless, the adverse effect of TD on survival rate, although reduced, remains after controlling for age (hazard ratio, 1.90; 95% confidence interval, 1.12-3.20; P = 0.017). Our finding showed a robust association with increased mortality rate and TD, but we failed to find any significant association with any specific cause of death and TD.

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The life expectancy of schizophrenic patients with tardive dyskinesia

Cited by 4 publications

References 17 publications

Movement Disorders and Mortality in Severely Mentally Ill Patients: The Curacao Extrapyramidal Syndromes Study XIV

Movement Disorders and Mortality in Severely Mentally Ill Patients: The Curacao Extrapyramidal Syndromes Study XIV

Tardive Dyskinesia Associated With Higher Mortality in Psychiatric Patients: Results of a Meta-Analysis of Seven Independent Studies

Mortality Rates Among Patients With Schizophrenia and Tardive Dyskinesia

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