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Participant responses (strongly agree/agree) stratified by dating and friendship domain videos showing individuals with/without TD
Source publication
Objective:
Antipsychotic medications may cause tardive dyskinesia (TD), an often-irreversible movement disorder characterized by involuntary movements that are typically stereotypic, choreiform, or dystonic and may impair quality of life. This study evaluated others' perceptions of abnormal TD movements in professional and social situations.
Meth...
Contexts in source publication
Context 1
... general, participant characteristics were balanced between the test and control groups for each survey in the mild-to-moderate and moderate-to-severe TD analyses after stratifying for professional actor characteristics (i.e., age, gender) or across videos of different professional actors (Supplementary Table 2; available online). ...Context 2
... ratings of agreement levels with the statements in the dating survey were lower in the test group than in the control group in both the mild-to-moderate and moderate-to-severe TD analyses ( Fig. 2A, Table 2), suggesting that participants had a more negative perception of the romantic potential of people showing TD movements than of those who did not. For the mild-to-moderate TD analyses, a significantly lower proportion of participants in the These questions were included in order to conceal the study objectives from the participants. ...Context 3
... ＜ 0.001). Similar results were obtained in the moderate-to-severe TD analyses (Fig. 2B, Table 2). In the subgroup analyses by professional actor, trends were generally similar to those in the overall group for both the mild-to-moderate and moderate-to-severe TD groups. ...Context 4
... ＜ 0.001). Results were similar in the moderate-to-severe TD analyses (Fig. 3B, Table 2). ...Context 5
... general, participant characteristics were balanced between the test and control groups for each survey in the mild-to-moderate and moderate-to-severe TD analyses after stratifying for professional actor characteristics (i.e., age, gender) or across videos of different professional actors (Supplementary Table 2; available online). ...Context 6
... ratings of agreement levels with the statements in the dating survey were lower in the test group than in the control group in both the mild-to-moderate and moderate-to-severe TD analyses ( Fig. 2A, Table 2), suggesting that participants had a more negative perception of the romantic potential of people showing TD movements than of those who did not. For the mild-to-moderate TD analyses, a significantly lower proportion of participants in the These questions were included in order to conceal the study objectives from the participants. ...Context 7
... ＜ 0.001). Similar results were obtained in the moderate-to-severe TD analyses (Fig. 2B, Table 2). In the subgroup analyses by professional actor, trends were generally similar to those in the overall group for both the mild-to-moderate and moderate-to-severe TD groups. ...Similar publications
Objective
To increase compliance with Abnormal Involuntary Movement Score (AIMS) documentation for patients taking antipsychotics to recognize and treat tardive dyskinesia in the psychiatry outpatient clinic.
Methods
The Lean Six Sigma quality improvement (QI) model, utilizing DMAIC steps of define, measure, analyze, improve, control, was followed....
Citations
... Tardive dyskinesia and tardive dystonia are associated with patient distress, decreased quality of life, and increased mortality [6,7]. Patients with tardive dyskinesia and tardive dystonia are also more likely to suffer from occupational and social stigmas [8]. ...
Tardive dyskinesia and dystonia are intractable extrapyramidal symptoms caused by the blockade of dopamine receptors by antipsychotic drugs. In addition to the reduction or discontinuation of the causative drug, valbenazine for tardive dyskinesia and botulinum toxin for tardive dystonia have been reported to be effective. However, their efficacy has not been fully demonstrated. In this study, we report the case of a female patient with bipolar disorder, valbenazine-resistant tardive dystonia, and tardive dyskinesia who achieved improvement in extrapyramidal symptoms with electroconvulsive therapy. Additionally, we conducted a narrative literature review on the safety and efficacy of electroconvulsive therapy for tardive dyskinesia and dystonia.
... T ardive dyskinesia (TD), an iatrogenic, hyperkinetic movement disorder, 1 interferes with voluntary motor functioning and evokes substantial social stigma. 2 TD is characterized by abnormal involuntary movements of the head, face, trunk, and extremities. 1 While the risk for TD increases with long-term use of dopamine receptor antagonists, 1 TD has also been reported after short treatment periods. ...
... 8 In addition, patients reported that negative reactions of strangers and acquaintances are common, consistent with a recent survey of the general population examining the stigma associated with TD movements. 2 The impact of TD reported via the WPAI on work absenteeism (29.1%), presenteeism (68.4%), and overall work impairment (73.5%) were greater than those reported for lung cancer (absenteeism, 15%; presenteeism, 31%; overall work impairment, 37%) 13 and for locally recurrent or metastatic breast cancer (20%, 30%, and 40%, respectively). 14 Patients with TD and MDD reported greater impact on absenteeism (22.1%), presenteeism (53.2%), and overall work impairment (58.8%) than previously recorded with the WPAI for US patients with MDD alone (absenteeism, 5.7%; presenteeism, 33.7%; and overall work impairment, 36.5%). ...
Objective: To assess the physical, psychological, social, and professional impact of tardive dyskinesia (TD) on patients in the United States. Methods: An online survey (April 2020-June 2021) to assess patient burden of TD was developed using targeted literature review and interviews with clinicians, patients, and caregivers. Survey participants (aged ≥ 18 years) with current diagnoses of TD and schizophrenia, bipolar disorder, or major depressive disorder rated the 7-day impact of TD on their physical, psychological, and social functioning via Likert scales (scored from 1 [least impact] to 5 [most impact]). Impact scores were calculated and summarized descriptively overall by self-reported disease severity and underlying disease. Participants also completed the Work Productivity and Activity Impairment Questionnaire and reported the impact of TD on their underlying psychiatric condition. Results: Overall, 269 patients (mean [SD] age = 40.6 years [9.9]; 74.7% employed) responded to the survey. Mean (SD) impact scores of 3.1 (0.9), 3.5 (1.0), and 3.2 (1.1) were reported in the physical, psychological, and social domains, respectively, and scores increased with reported TD symptom severity. Patients with underlying schizophrenia reported the highest burden for all domains. Patients reported 66.2% activity impairment because of TD. Employed patients (n = 193) indicated 29.1% absenteeism, 68.4% presenteeism, and 73.5% overall work impairment. Over one-third of patients reported skipping/reducing (48.4%) or stopping (39.3%) their antipsychotic medication and stopping visits to clinicians treating their underlying condition (35.7%) because of TD. Conclusion: TD imposes a substantial burden on patients' physical, psychological, social, and professional lives and impacts management of their underlying condition.
... 120,127 While severe TD may impair functioning in all affected people, even mild TD may have profound effects on an individual. 128 Recent studies have documented the impact of TD and piloted the use of rating scales that incorporate functional measures. Additional evidence is needed on the predictive validity of AIMS scores in determining the effect of TD on functioning and quality of life. ...
Tardive dyskinesia (TD) is a heterogeneous, hyperkinetic movement disorder induced by dopamine-receptor blocking agents that presents a unique challenge in the treatment of psychosis. Although acceptance of TD as a serious consequence of antipsychotic treatment was resisted initially, subsequent research by many investigators in psychopharmacology contributed to a rich store of knowledge on many aspects of the disorder. While basic neuroscience investigations continue to deepen our understanding of underlying motor circuitry, past trials of potential treatments of TD focusing on a range of theoretical targets were often inconclusive. Development of newer antipsychotics promised to reduce the risk of TD compared to older drugs, but their improved tolerability unexpectedly enabled an expanding market that paradoxically both increased the absolute number of patients at risk and diminished attention to TD which was relegated to legacy status. Fortunately, development and approval of novel vesicular monoamine transporter inhibitors offered evidence-based symptomatic treatment of TD for the first time and rekindled interest in the disorder. Despite recent progress, many questions remain for future research including the mechanisms underlying TD, genetic predisposition, phenomenological diversity, whether new cases are reversible, how to implement best practices to prevent and treat TD, and whether the development of novel antipsychotics free of the risk of TD is attainable. We owe our patients the aspirational goal of striving for zero prevalence of persistent symptoms of TD in anyone treated for psychosis.
... For example, social isolation has been reported by 72.7% of the patients with TD and 18.2% of the caregivers, making it among the most commonly reported negative impacts of TD. 16 In addition, TD in patients with schizophrenia is correlated to decreased likelihood for marriage, 32 and individuals with orofacial TD symptoms are perceived as being less socially acceptable and as less favorable potential friends and romantic partners. 33,34 Physical Functioning ...
... More than half of patients with TD reported that their employment status was "disabled" (P = 0.0027 vs patients without TD). 2 Stigma associated with TD can also lead to a perception that individuals with orofacial symptoms are less employable than individuals without TD. 33,34 Negative effects on employment may also be a result of patients with uncontrolled TD avoiding public places and attempting to hide their abnormal movements. 27 Psychological Functioning TD can cause patients to develop odd postures and movements that can invite ridicule and ostracism. ...
... Physical symptoms of TD can impact communication; swallowing, eating, dentition; gait and posture; and ability to perform activities of daily living (eg, writing, use of technology, self-care). 19 These physical effects can significantly impact social relationships [32][33][34] and the ability to obtain or maintain employment 2 ; can lead to feelings of shame, embarrassment, and helplessness; and can impair psychological functioning. 11 TD can also have a negative impact on a patient's underlying psychiatric illness. ...
Purpose
Tardive dyskinesia (TD) is a hyperkinetic movement disorder in which patients experience abnormal involuntary movements that can have profound negative impacts on physical, cognitive, and psychosocial functioning. Use of measures to assess the functional impact of TD in routine clinical practice is lacking. To address this gap, an advisory panel of experts in psychiatry and movement disorder neurology was convened to develop consensus recommendations on assessment of the impact of TD on patients’ functioning that can be used in clinical practice.
Methods
An advisory panel provided recommendations using an iterative process, beginning with a narrative literature review regarding current practices for assessing the impact of TD in clinical settings. A detailed summary was generated, and the advisory panel provided comments about the content and answered questions about assessing TD impact in clinical practice. The panelists’ responses were discussed during a virtual meeting held on August 28, 2020. A second meeting on September 25, 2020, focused on developing and refining recommendations for assessment of the impact of TD in clinical practice. At the conclusion of the second meeting, general consensus was reached on all recommendation statements.
Results
As part of routine clinical practice, it is imperative to assess the impact of TD on the patient’s life to help guide treatment decisions. Key domains for assessing the overall impact of TD include social, physical, vocational, and psychological functioning and the impact of TD on the underlying psychiatric disorder. Assessment of TD impact should be performed at every patient visit. Impact assessments should include consultation with patients, caregivers, and family members. Shared decision-making to initiate TD treatment should consider impact.
Conclusion
The impact of TD should be assessed routinely, including the key domains of social, physical, vocational, and psychological functioning and the impact of TD on the underlying psychiatric disorder.
Purpose
This study aimed to assess the association between antipsychotic doses and the risk of tardive dyskinesia (TD) in clinical practice using a Japanese claims database from 2010 to 2020.
Methods
The study population included patients 15 years or older with a diagnosis record of schizophrenia, depression, or bipolar disorder who were prescribed antipsychotics. Using a case-control design, we categorized patients newly diagnosed with TD as cases, with corresponding 1:10 matching in the control group. The primary endpoint was the relative risk of TD in the >median dose and ≤median dose groups, as determined using conditional logistic regression analysis adjusted for age.
Results
The analysis population included 58,452 patients, and the median daily antipsychotic dose was 75 mg/d of chlorpromazine equivalent (CPZE). Of these, 80 were identified as TD cases, and doses >75 mg/d were associated with a significantly increased risk of TD at the last prescription and the maximum dose, respectively, before the date of the first diagnosis of TD. Post-hoc analysis further showed a significant association between doses ≥300 mg/d and the risk of TD compared to doses ≤75 mg/d and doses >75 to <300 mg/d. Comparing ≥300 mg/d versus >75 to <300 mg/d, the odd ratios at the last prescription and maximum dose before the first diagnosis of TD were 3.40 and 3.50, respectively.
Conclusions
In the Japanese medical claims database of patients receiving relatively low doses of antipsychotics, doses >75 mg/d were associated with an increased risk of TD in a dose-dependent manner.
Purpose/background:
Tardive dyskinesia (TD) is a hyperkinetic movement disorder caused by exposure to dopamine-receptor blockers. Data on TD burden in Israel are scarce. This analysis assesses the clinical and economic burden of TD in Israeli patients.
Methods/procedures:
This retrospective analysis used a national health plan database (Maccabi Healthcare Services), representing 25% of the Israeli population. The study included adults alive at index date with an International Classification of Diseases, Ninth Revision, Clinical Modification TD diagnosis before 2018 and more than or equal to 1-year enrollment before diagnosis. Tardive dyskinesia patients were matched to non-TD patients (1:3) by underlying psychiatric condition, birth year, and sex. Treatment patterns and 2018 annual health care resource utilization and costs were assessed.
Findings/results:
Of 454 TD patients alive between 2013 and 2018, 333 alive on January 1, 2018, were matched to 999 non-TD patients. At baseline, TD patients had lower socioeconomic status and higher proportion of chronic kidney disease and antipsychotic medication use; all analyses were adjusted accordingly. Tardive dyskinesia patients had significantly more visits to general physicians, neurologists, psychiatrists, physiotherapists, and emergency departments versus non-TD patients (all P < 0.05). Tardive dyskinesia patients also had significantly longer hospital stays than non-TD patients (P = 0.003). Total healthcare and medication costs per patient were significantly higher in the TD versus non-TD population (US 7145, P = 0.018).
Implications/conclusions:
Israeli TD patients have higher clinical and economic burden than non-TD patients. Understanding real-world health care resource utilization and costs allows clinicians and decision makers to quantify TD burden and prioritize resources for TD patients' treatment.
