Psychiatric Center Symfora Group, DB, Amersfoort, The Netherlands.
Mov Disord. 2009 Dec 15;24(16):2309-15. doi: 10.1002/mds.22707.
A meta-analysis of prospective studies with schizophrenia patients was conducted to examine whether the evidence exists for risk factors for the emergence of Tardive Dyskinesia (TD) in schizophrenia. A computer assisted Medline/PubMed and Embase search was conducted in January 2008 for the years 1985-2007. Selected were truly prospective studies of incident cases of TD in a population with at least 80% patients with schizophrenia. Measures of relative risk were collected from the individual studies, either directly or by calculating the relative risk from the cox- or logistic regression coefficient provided in the article. Hazard Ratio's and Odds Ratio's were pooled using fixed and random effect models in case of multiple studies using the same measure of risk and outcome. Only eight studies satisfied the inclusion criteria reporting on 25 different single estimate risk factors. Of 25 risk factors, six concerned replicated estimates suitable for meta-analysis. Of these, non-white ethnic group and early extrapyramidal symptoms qualified as risk factors for the emergence of TD in schizophrenia. The association with older age was suggestive but inconclusive. Despite many reported risk factors for TD in schizophrenia, little conclusive evidence exists to corroborate this. However, the fact that early EPS predicts onset of TD has important clinical and research implications.
对伴有精神分裂症患者的前瞻性研究进行了荟萃分析，以检验精神分裂症迟发性运动障碍（TD）出现的危险因素是否存在。2008 年 1 月，使用计算机辅助 Medline/PubMed 和 Embase 搜索了 1985 年至 2007 年的文献。选择的是至少 80%患者为精神分裂症的前瞻性研究，以研究 TD 的发病情况。从个体研究中收集相对风险的测量值，直接从文章中提供的 cox 或逻辑回归系数计算，或者直接从文章中提供的 cox 或逻辑回归系数计算。如果多个研究使用相同的风险和结果衡量标准，则使用固定和随机效应模型汇总风险比和优势比。只有八项研究符合纳入标准，报告了 25 种不同的单一估计风险因素。在 25 种风险因素中，有 6 种涉及可用于荟萃分析的重复估计值。其中，非白种人群和早期锥体外系症状是精神分裂症 TD 出现的危险因素。与年龄较大的相关性提示存在相关性，但尚无定论。尽管有许多报道称精神分裂症存在 TD 的风险因素，但很少有确凿的证据可以证实这一点。然而，早期 EPS 预测 TD 发作这一事实具有重要的临床和研究意义。
