This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Their Association in Relation to Topography of Involuntary Movements and Criterion of Their Abnormality

John L. Waddington, PhD; Hanafy A. Youssef, MRCPsych; Ciaran Dolphin, MSc; Anthony Kinsella, MSc, FIS

Arch Gen Psychiatry. 1987;44(10):907-912.

Abstract
• Little is known of factors that, on an individual basis, confer vulnerability to the emergence of involuntary movements (tardive dyskinesia) during long-term neuroleptic treatment. In this study of 88 chronic schizophrenic inpatients, 22 variables (four demographic, 14 medication history, and four features of illness) were compared for any association(s) with the presence, by differing topographies and criteria of abnormality, and severity of involuntary movements. Irrespective of the criterion used, the presence of marked cognitive dysfunction—muteness bore a consistent and highly significant primary association with both the presence and the overall severity of orofacial dyskinesia; no such association was found in relation to the presence of limb-truncal dyskinesia. Flattening of affect was the only other variable consistently associated with the presence of orofacial movements. The reliability and prominence of the association between the presence of orofacial, but not of limb-truncal, movements and cognitive dysfunction—negative symptoms suggest that these varying topographies may not constitute a unitary syndrome. This strong association, not with indexes of neuroleptic exposure but rather with features of the illness for which that treatment was prescribed, suggests some neurologic process, more subtle than may previously have been appreciated, as a vulnerability factor of some importance. In schizophrenia it appears to be intimately related to the disease process.

Author Affiliations
From the Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin (Dr Waddington); St Davnet's Hospital, Monaghan, Ireland (Dr Youssef); the Dublin Institute of Technology (Mr Kinsella); and the Irish Foundation for Human Development, Dublin (Mr Dolphin).

Footnotes
Accepted for publication March 4, 1987.

Reprint requests to the Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland (Dr Waddington).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Spatial Working Memory Deficits in Schizophrenia: Relationship With Tardive Dyskinesia and Negative Symptoms
Pantelis et al.
Am. J. Psychiatry 2001;158:1276-1285.
ABSTRACT | FULL TEXT  

Dementia as a complication of schizophrenia
de Vries et al.
J. Neurol. Neurosurg. Psychiatry 2001;70:588-596.
ABSTRACT | FULL TEXT  

Typical Neuroleptics and Increased Subcortical Volumes
DEAN
Am. J. Psychiatry 1999;156:1843--1844.
FULL TEXT  

Spontaneous Abnormal Involuntary Movements in First-Episode Schizophrenia and Schizophreniform Disorder: Baseline Rate in a Group of Patients From an Irish Catchment Area
Gervin et al.
Am. J. Psychiatry 1998;155:1202-1206.
ABSTRACT | FULL TEXT  

Intermittent Neuroleptic Treatment and Risk for Tardive Dyskinesia: Curacao Extrapyramidal Syndromes Study III
van Harten et al.
Am. J. Psychiatry 1998;155:565-567.
ABSTRACT | FULL TEXT  

Spontaneous Dyskinesia in Subjects With Schizophrenia Spectrum Personality
Cassady et al.
Am. J. Psychiatry 1998;155:70-75.
ABSTRACT | FULL TEXT  

Incidence and Correlates of Tardive Dyskinesia in First Episode of Schizophrenia
Chakos et al.
Arch Gen Psychiatry 1996;53:313-319.
ABSTRACT  

Signs and Symptoms: What Can They Tell Us About the Clinical Course and Pathophysiologic Processes of Schizophrenia?
Lieberman
Arch Gen Psychiatry 1995;52:361-363.
ABSTRACT  

Risk Factors for Spontaneous Dyskinesia in Schizophrenia
Fenton et al.
Arch Gen Psychiatry 1994;51:643-650.
ABSTRACT  

Schizophrenia and Temporal Lobe Epilepsy: A Neuropsychological Analysis
Gold et al.
Arch Gen Psychiatry 1994;51:265-272.
ABSTRACT  

The Positive-Negative Distinction in Schizophrenia: Review of Natural History Validators
McGlashan and Fenton
Arch Gen Psychiatry 1992;49:63-72.
ABSTRACT