Chong S A, Remington G, Mahendran R, Chua H C
Department of Adult Psychiatry, Woodbridge Hospital & Institute of Mental Health, Singapore.
J Clin Psychopharmacol. 2001 Apr;21(2):235-7. doi: 10.1097/00004714-200104000-00017.
While ethnocultural differences in risk of tardive dyskinesia (TD) have been suggested, no previous studies have examined whether this factor also plays a role in lack of awareness of TD. This study examined this question in an Asian population with schizophrenia. Six hundred seven patients in a state mental hospital in Singapore were assessed using the Abnormal Involuntary Movement Scale (AIMS) and the Simpson-Angus Rating Scale. Of the 607 patients, 242 (39.9%) met criteria for TD, and 163 (67.4%) patients were not aware of the presence of TD. No significant differences in terms of age, gender, and duration of illness were found between those aware of their TD and those not aware. Daily neuroleptic doses and scores for the AIMS and Simpson-Angus Rating Scale were significantly different, although after logistic regression, only the Simpson-Angus Rating Scale scores remained significant. The finding that a large proportion of our patients lacked awareness of their TD is consistent with other reports in the West and provides evidence that this feature is characteristic of the illness rather than of a specific ethnocultural group. We found an association between lack of awareness and greater severity of extrapyramidal symptoms (EPS), suggesting that there may be a subtype of TD in which lack of awareness and greater vulnerability of developing EPS are features.
虽然有研究表明迟发性运动障碍（TD）的风险存在种族文化差异，但之前没有研究探讨过这一因素是否也在TD的自知缺失中起作用。本研究在患有精神分裂症的亚洲人群中对这一问题进行了调查。使用异常不自主运动量表（AIMS）和辛普森-安格斯评定量表对新加坡一家国立精神病院的607名患者进行了评估。在这607名患者中，242名（39.9%）符合TD标准，163名（67.4%）患者不知道自己患有TD。在自知TD的患者和不自知TD的患者之间，未发现年龄、性别和病程方面的显著差异。每日抗精神病药物剂量以及AIMS和辛普森-安格斯评定量表的得分存在显著差异，尽管在进行逻辑回归分析后，只有辛普森-安格斯评定量表得分仍具有显著性。我们的患者中有很大一部分缺乏TD自知力这一发现与西方的其他报告一致，并提供了证据表明这一特征是该疾病的特点，而非特定种族文化群体所特有。我们发现自知缺失与锥体外系症状（EPS）的更严重程度之间存在关联，这表明可能存在一种TD亚型，其特征是自知缺失和发生EPS的易感性更高。
