Sweet R A, Mulsant B H, Rifai A H, Zubenko G S
Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213.
J Geriatr Psychiatry Neurol. 1992 Jul-Sep;5(3):156-61. doi: 10.1177/002383099200500305.
A wide variation in prevalence rates of tardive dyskinesia and spontaneous orofacial dyskinesia has been reported in the elderly. To clarify these discrepancies, we studied 45 patients over the age of 60 years admitted to a short-term psychiatric unit. Standardized criteria for the diagnosis of dyskinesia were used. We found a rate of tardive dyskinesia of only 21% (7/33) in our patients having a history of neuroleptic exposure. We found no cases (0/12) of spontaneous orofacial dyskinesia. There was a significant association between tardive dyskinesia and psychiatric diagnosis, with the highest rate of tardive dyskinesia in those patients with schizophrenic disorders, followed by those with organic disorders and mood disorders, respectively. There was also a significant association between the presence of tardive dyskinesia and radiographic evidence of cortical atrophy, and a trend towards an association with leukoencephalopathy. Our results suggest that published rates of tardive and spontaneous dyskinesia in the elderly may overestimate the prevalence of these disorders, especially among geriatric patients with acute psychiatric presentations.
据报道，迟发性运动障碍和自发性口面部运动障碍在老年人中的患病率差异很大。为了澄清这些差异，我们研究了45名60岁以上入住短期精神科病房的患者。采用了运动障碍诊断的标准化标准。我们发现，有抗精神病药物暴露史的患者中，迟发性运动障碍的发生率仅为21%（7/33）。我们未发现自发性口面部运动障碍病例（0/12）。迟发性运动障碍与精神疾病诊断之间存在显著关联，精神分裂症患者中迟发性运动障碍的发生率最高，其次分别是器质性疾病和情绪障碍患者。迟发性运动障碍的存在与皮质萎缩的影像学证据之间也存在显著关联，并且与白质脑病存在关联趋势。我们的结果表明，已发表的老年人迟发性和自发性运动障碍的发生率可能高估了这些疾病的患病率，尤其是在患有急性精神疾病的老年患者中。
