Glazer W M, Morgenstern H, Schooler N, Berkman C S, Moore D C
Yale University School of Medicine, Department of Psychiatry, New Haven, Connecticut 06519.
Br J Psychiatry. 1990 Oct;157:585-92. doi: 10.1192/bjp.157.4.585.
Forty-nine chronic psychiatric out-patients (ten were schizophrenic) with tardive dyskinesia (TD) were examined monthly for a mean of 40 weeks (range 1-59 months) after discontinuation of neuroleptic medication. Complete and persistent reversibility of TD was rare (2%), but many patients showed noticeable improvement in movements within the first year of discontinuation, which was sometimes interrupted by psychological relapse. Using three separate outcome measures and appropriate model-fitting techniques for each, we identified several predictors of improvement in TD, including an affective or schizoaffective psychiatric diagnosis, chronic (over 20 years) psychiatric illness, being employed, younger age, and increased neuroleptic dose before discontinuation. Consistent findings emerging from these analyses suggest that the type and history of psychiatric illness affect the course of TD.
四十九名患有迟发性运动障碍(TD)的慢性精神科门诊患者(其中十名是精神分裂症患者)在停用抗精神病药物后每月接受检查,平均检查40周(范围为1 - 59个月)。TD完全且持续可逆的情况很少见(2%),但许多患者在停药后的第一年内运动有明显改善,这种改善有时会因心理复发而中断。我们使用三种不同的结局指标,并针对每种指标采用适当的模型拟合技术,确定了TD改善的几个预测因素,包括情感性或分裂情感性精神科诊断、慢性(超过20年)精神疾病、就业、年龄较小以及停药前抗精神病药物剂量增加。这些分析中出现的一致结果表明,精神疾病的类型和病史会影响TD的病程。