Gharabawi Georges M, Bossie Cynthia A, Lasser Robert A, Turkoz Ibrahim, Rodriguez Stephen, Chouinard Guy
Medical Affairs Division, Janssen Pharmaceutica Products, L.P., Titusville, NJ 08560, USA.
Schizophr Res. 2005 Sep 15;77(2-3):119-28. doi: 10.1016/j.schres.2005.03.008.
Assessing tardive dyskinesia (TD) has been complicated by the use of different research criteria and rating scales. We studied concordance between two commonly used scales, the Abnormal Involuntary Movement Scale (AIMS) and Extrapyramidal Symptom Rating Scale (ESRS), to study interscale concordance and criteria to define TD. Patients with schizophrenia or schizoaffective disorder (N = 374) were rated at baseline with both scales. Linear and logistic regression models explored relationships between scale ratings and mapped scores for corresponding items. TD was defined as at least mild in > or = 2 anatomical areas, or moderate or greater symptoms in > or = 1 area at baseline. Logistic regression was used to find simplified criteria for predicting AIMS-defined TD by ESRS scores. There was a strong association on corresponding item ratings. "Mild" was defined as AIMS score of 2 and ESRS 2 or 3, and "moderate or greater" as AIMS score > or = 3 and ESRS > or = 4. Using these criteria, there was 96.0% (359/374) agreement between AIMS- and ESRS-defined TD cases. The ESRS Clinical Global Impressions of severity of dyskinesia (CGI-SD) best predicted AIMS-defined TD. An ESRS CGI-SD > or = 4 (95% CI: 3.61, 4.76) was associated with > or = 95% probability of AIMS-defined TD. High concordance between the scales for dyskinesia scores was found. Findings suggest that the ESRS CGI-SD score can serve as a simplified criterion for identifying AIMS-defined TD, and may be a useful tool for future research-based TD analyses, when occurring in the context of a full movement disorder assessment.
由于使用了不同的研究标准和评定量表,迟发性运动障碍(TD)的评估变得复杂。我们研究了两种常用量表,即异常不自主运动量表(AIMS)和锥体外系症状评定量表(ESRS)之间的一致性,以研究量表间的一致性及定义TD的标准。对374例精神分裂症或分裂情感性障碍患者在基线时使用这两种量表进行评定。线性和逻辑回归模型探讨了量表评分与相应项目映射分数之间的关系。TD被定义为在基线时至少在2个解剖区域有轻度及以上症状,或在1个区域有中度及以上症状。使用逻辑回归来寻找通过ESRS分数预测AIMS定义的TD的简化标准。相应项目评分之间存在很强的相关性。“轻度”定义为AIMS评分为2且ESRS为2或3,“中度及以上”定义为AIMS评分≥3且ESRS≥4。使用这些标准,AIMS定义的TD病例与ESRS定义的TD病例之间的一致性为96.0%(359/374)。ESRS的运动障碍严重程度临床总体印象(CGI-SD)最能预测AIMS定义的TD。ESRS CGI-SD≥4(95%CI:3.61,4.76)与AIMS定义的TD的概率≥95%相关。发现运动障碍评分量表之间具有高度一致性。研究结果表明,ESRS CGI-SD评分可作为识别AIMS定义的TD的简化标准,并且在全面运动障碍评估的背景下,可能是未来基于研究的TD分析的有用工具。