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药物性迟发性运动障碍的研究:口面部肌肉受累及患者的认知

A Study on Drug-Induced Tardive Dyskinesia: Orofacial Musculature Involvement and Patient's Awareness.

作者信息

Anusa Arunachalam M, Thavarajah Rooban, Nayak Dinesh, Joshua Elizabeth, Rao Umadevi Krishnamohan, Ranganathan Kannan

机构信息

Department of Psychiatry, Affiliated to Sri Balaji Vidyapeeth, Shri Sathya Sai Medical College and Research Institute, Kanchipuram.

Marundeeshwara Oral Pathology Services and Analytics, Ragas Dental College and Hospital, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University.

出版信息

J Orofac Sci. 2018 Jul-Dec;10(2):86-95. Epub 2019 Jan 2.

Abstract

OBJECTIVE

Schizophrenia is a psychiatric disorder that requires long-term treatment. Long-term antipsychotic treatment is often associated with the emergence of tardive dyskinesia (TD), the severity of which is measured by Abnormal Involuntary Movement Scale (AIMS). This study examined the relationship among TD, orofacial musculature activity, and patient's awareness of AIM. The knowledge would help dentists to deliver oral care for schizophrenics with TD.

MATERIALS AND METHODS

We identified 317 patients from a standard, data sharing initiative, of whom 38.3% exhibited AIM score of 2 to 15. The patient demographics, drug history, details of AIMS were subjected to descriptive and inferential statistical analysis using SPSS with ≤0.05 as significance.

RESULTS

The mean of only orofacial features ( = 56) was 3.43 ± 2.68. Muscles of facial expression was involved in nine (7.9% of all TD), lip/perioral area in 27 (23.68%), jaw in 52 (45.61%), and tongue in 77 (67.54%). The patient's perception of AIM precipitated stress when involving jaw, tongue, limbs, and trunk was statistically significant (≤0.05). The multiple regression model statistically significantly predicted TD for factors considered.

CONCLUSION

Around 1% of global population is being diagnosed with schizophrenia, carry an inherent risk of developing TD. They might have orodental care requirements, including prosthodontic and restorative services. Primary physicians and dentists need to be aware of TD and its mechanism for appropriate patient management.

摘要

目的

精神分裂症是一种需要长期治疗的精神疾病。长期使用抗精神病药物治疗常与迟发性运动障碍(TD)的出现相关,其严重程度通过异常不自主运动量表(AIMS)来衡量。本研究探讨了TD、口面部肌肉活动与患者对AIMS的认知之间的关系。这些知识将有助于牙医为患有TD的精神分裂症患者提供口腔护理。

材料与方法

我们从一项标准的数据共享计划中识别出317名患者,其中38.3%的患者AIMS评分为2至15分。使用SPSS对患者的人口统计学特征、用药史、AIMS的详细信息进行描述性和推断性统计分析,以≤0.05为显著性水平。

结果

仅口面部特征(n = 56)的平均值为3.43±2.68。面部表情肌受累9例(占所有TD的7.9%),唇/口周区域27例(23.68%),颌部52例(45.61%),舌部77例(67.54%)。当涉及颌部、舌部、四肢和躯干时,患者对AIMS的感知引发压力具有统计学意义(≤0.05)。多元回归模型对所考虑的因素具有统计学意义地预测了TD。

结论

全球约1%的人口被诊断为精神分裂症,有患TD的内在风险。他们可能有口腔牙科护理需求,包括假牙修复和修复服务。初级医生和牙医需要了解TD及其机制,以便对患者进行适当管理。

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Tardive dyskinesia is associated with greater cognitive impairment in schizophrenia.迟发性运动障碍与精神分裂症患者认知功能损害程度增加相关。
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本文引用的文献

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Tardive dyskinesia: Epidemiology.迟发性运动障碍:流行病学。
J Neurol Sci. 2018 Jun 15;389:17-20. doi: 10.1016/j.jns.2018.02.007. Epub 2018 Feb 5.
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Why a radical overhaul of dentistry is needed.为何牙科需要彻底变革。
Indian J Dent Res. 2017 Sep-Oct;28(5):471-474. doi: 10.4103/ijdr.IJDR_449_17.

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