Gebhardt Stefan, Härtling Fabian, Hanke Markus, Mittendorf Markus, Theisen Frank M, Wolf-Ostermann Karin, Grant Phillip, Martin Matthias, Fleischhaker Christian, Schulz Eberhard, Remschmidt Helmut
Dept. of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Strasse 8, 35033 Marburg, Germany.
Eur Child Adolesc Psychiatry. 2006 Oct;15(7):371-82. doi: 10.1007/s00787-006-0544-5. Epub 2006 Apr 28.
To examine prevalence of movement disorders (MDs) such as tardive dyskinesia (TD), parkinsonism or akathisia in an adolescent population with schizophrenia and in relationship to predominantly atypical antipsychotic treatment.
Ninety-three patients (aged 19.6+/-2.2 years) were ascertained in this cross-sectional/retrospective study. 76 patients (81.7%) received atypical, 10 (10.8%) typical antipsychotics and 7 (7.5%) combinations of atypical/typical antipsychotics. MD symptoms were assessed using Tardive Dyskinesia Rating Scale (TDRS), Abnormal Involuntary Movement Scale (AIMS), Extrapyramidal Symptom Scale (EPS), Barnes Akathisia Scale (BAS).
Movement disorder symptoms were found in 37 patients (39.8%) fulfilling strict/subthreshold criteria for TD (5.4/11.8%), parkinsonism (2.2/25.8%) or akathisia (1.1/11.8%), respectively. Patients treated with typical antipsychotics displayed a significantly higher EPS-score (P=0.036) and a tendency towards a higher BAS-score (P=0.061) compared to patients with atypical antipsychotics. Treatment durations with typical/atypical antipsychotics showed trends towards advantages of atypical antipsychotics with regard to parkinsonism/akathisia symptoms (P=0.061; P=0.054), but not with regard to TD symptoms (P=0.003), possibly due to confounding effects.
Under treatment with atypical antipsychotics MD symptoms are less prevalent and less pronounced than under typical antipsychotics. We speculate that the finding of relatively high prevalence rates of subthreshold MD symptoms may be, at least partially, explained by previous or combined therapy with typical antipsychotics.
研究精神分裂症青少年人群中迟发性运动障碍（TD）、帕金森症或静坐不能等运动障碍（MD）的患病率，以及与主要使用非典型抗精神病药物治疗的关系。
在这项横断面/回顾性研究中确定了93名患者（年龄19.6±2.2岁）。76名患者（81.7%）接受非典型抗精神病药物治疗，10名（10.8%）接受典型抗精神病药物治疗，7名（7.5%）接受非典型/典型抗精神病药物联合治疗。使用迟发性运动障碍评定量表（TDRS）、异常不自主运动量表（AIMS）、锥体外系症状量表（EPS）、巴恩斯静坐不能量表（BAS）评估MD症状。
分别有37名患者（39.8%）出现符合TD严格/亚阈值标准（5.4/11.8%）、帕金森症（2.2/25.8%）或静坐不能（1.1/11.8%）的运动障碍症状。与接受非典型抗精神病药物治疗的患者相比，接受典型抗精神病药物治疗的患者EPS评分显著更高（P=0.036），BAS评分有升高趋势（P=0.061）。典型/非典型抗精神病药物的治疗时长显示，在帕金森症/静坐不能症状方面非典型抗精神病药物有优势趋势（P=0.061；P=0.054），但在TD症状方面没有（P=0.003），可能是由于混杂效应。
与典型抗精神病药物治疗相比，非典型抗精神病药物治疗下MD症状的患病率更低且症状不那么明显。我们推测，亚阈值MD症状相对较高的患病率这一发现，至少部分可以用先前使用典型抗精神病药物治疗或联合治疗来解释。
