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迟发性运动障碍:识别、患者评估和鉴别诊断。

Tardive Dyskinesia: Recognition, Patient Assessment, and Differential Diagnosis.

机构信息

Department of Psychiatry, Texas Tech University Health Sciences Center Medical School, Midland, Texas USA.

Private Practice, Austin, Texas, USA.

出版信息

J Clin Psychiatry. 2018 Mar/Apr;79(2). doi: 10.4088/JCP.nu17034ah1c. Epub 2018 Mar 20.

Abstract

Tardive dyskinesia (TD) is an involuntary movement disorder associated with antipsychotic treatment. Because of the serious and potentially irreversible nature of TD, accurate diagnosis is crucial. However, diagnosing TD can be challenging, since the subtle and often fluctuating symptoms can be easily mistaken for symptoms of mental illness or other side effects. Although the risk of developing TD in relation to treatment with second-generation antipsychotics is lower than that associated with first-generation antipsychotics, the risk still exists and may be greater than once believed. Clinicians prescribe antipsychotics for a variety of illnesses and may underestimate the possibility of a patient developing TD, thus missing early signs of the disorder. In this ACADEMIC HIGHLIGHTS, experts review the prevalence, phenomenology, risk factors, and impact of TD, illustrated by case examples, and provide valuable clinical information to guide early recognition and accurate diagnosis.

摘要

迟发性运动障碍(TD)是一种与抗精神病药物治疗相关的不自主运动障碍。由于 TD 具有严重且潜在不可逆的性质,因此准确的诊断至关重要。然而,TD 的诊断具有挑战性,因为其微妙且经常波动的症状容易与精神疾病或其他副作用的症状混淆。尽管与第二代抗精神病药物治疗相关的 TD 风险低于第一代抗精神病药物,但仍存在风险,且可能比以往认为的更大。临床医生为各种疾病开具抗精神病药物,可能低估患者发生 TD 的可能性,从而错过该疾病的早期迹象。在这篇学术亮点中,专家通过病例示例回顾了 TD 的患病率、现象学、危险因素和影响,并提供了有价值的临床信息,以指导早期识别和准确诊断。

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