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首页> 外文期刊>The journal of clinical psychiatry >Incidence of tardive dyskinesia and tardive dystonia in African Caribbean patients on long-term antipsychotic treatment: the Curacao extrapyramidal syndromes study V.
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Incidence of tardive dyskinesia and tardive dystonia in African Caribbean patients on long-term antipsychotic treatment: the Curacao extrapyramidal syndromes study V.

机译：长期抗精神病药物治疗对非洲加勒比海地区患者的迟发性运动障碍和迟发性肌张力障碍的发生率：库拉索岛锥体外系综合征研究V。

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OBJECTIVE: Tardive dyskinesia (TD) and tardive dystonia (TDt) syndromes represent severe side effects of first-generation antipsychotics (FGAs). Although second-generation antipsychotics (SGAs) confer a lower risk for tardive syndromes, many patients continue to use FGAs alone or in combination with SGAs. Some patients remain free of TD or TDt even after many years of antipsychotic treatment with predominantly FGAs. Do these patients remain at risk for TD or TDt and, consequently, should a switch to SGAs be considered? A longitudinal cohort study in patients on long-term antipsychotic treatment may answer this question. METHOD: A 9-year cohort study (1992-2001) was conducted of the whole, mostly chronic, psychiatric inpatient population on the Caribbean island of Curacao (N = 194). Almost all patients (95%) were of African Carribean origin. TD and TDt were assessed (1 baseline, 6 follow-ups) with the Abnormal Involuntary Movement Scale and the Fahn-Marsden rating scale, respectively. New cases of TD orTDt were diagnosed if they fulfilled the criteria at 2 successive follow-up visits. RESULTS: In patients with a mean antipsychotic use of approximately 18 years, the yearly incidence rates of TD and TDt were 10.2% (95% CI = 7.7 to 13.5) and 0.7% (95% CI = 0.4 to 1.5), respectively. The severity of TD was strongly associated with the severity of TDt (beta = 0.08, 95% CI = 0.03 to 0.14) and vice versa (beta = 0.10, 95% CI = 0.03 to 0.16). TD severity was positively associated with age and akathisia but negatively associated with parkinsonism. CONCLUSIONS: Patients who are free of TD after many years of antipsychotic treatment still have a considerable risk for TD. Switching to an SGA may be warranted. The risk for incident TDt in this group was very low.
机译：目的：迟发性运动障碍（TD）和迟发性肌张力障碍（TDt）综合征代表第一代抗精神病药（FGA）的严重副作用。尽管第二代抗精神病药（SGA）降低了迟发综合征的风险，但许多患者仍继续单独或与SGA联合使用FGA。即使经过以FGAs为主的抗精神病药物治疗多年后，一些患者仍然没有TD或TDt。这些患者是否仍然存在TD或TDt的风险，因此是否应考虑改用SGA？对接受长期抗精神病药物治疗的患者进行的纵向队列研究可能会回答这个问题。方法：对加勒比海库拉索岛（N = 194）的全部（大部分为慢性精神病患者）住院患者进行了为期9年的队列研究（1992-2001年）。几乎所有患者（95％）都来自非洲加勒比海地区。分别使用异常非自愿运动量表和Fahn-Marsden量表对TD和TDt进行了评估（1个基线，6个随访）。如果新的TD或TDt病例在连续2次随访中符合标准，则被诊断出。结果：在平均抗精神病药物使用时间约为18年的患者中，TD和TDt的年发病率分别为10.2％（95％CI = 7.7至13.5）和0.7％（95％CI = 0.4至1.5）。 TD的严重程度与TDt的严重程度密切相关（β= 0.08，95％CI = 0.03至0.14），反之亦然（β= 0.10，95％CI = 0.03至0.16）。 TD严重程度与年龄和静坐无力呈正相关，而与帕金森综合症呈负相关。结论：经过多年抗精神病治疗后没有TD的患者仍然有相当大的TD风险。可能需要切换到SGA。该组中发生TDt的风险非常低。

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