Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia.
PLoS One. 2020 Jul 2;15(7):e0235365. doi: 10.1371/journal.pone.0235365. eCollection 2020.
To determine the magnitude and factors associated with psychotropic drug-induced parkinsonism and akathisia among mentally ill patients.
A hospital-based cross-sectional study was conducted with a total of 410 participants attending a follow-up treatment service at Jimma Medical Center, a psychiatry clinic from April to June 2019. Participants were recruited using a systematic random sampling method. Drug-induced parkinsonism and akathisia were assessed using the Extra-pyramidal Symptom Rating Scale. Substance use was assessed using the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test. Data entry was done using EpiData version 3.1, and analysis done by the Statistical Package for Social Sciences version 22. Statistically, the significant association was declared by adjusted odds ratio, 95% confidence interval, and p-value less than or equal to 0.05.
The mean age of the respondents was 33.3 years (SD ± 8.55). Most of the participants 223 (54.4%) had a diagnosis of schizophrenia. The prevalence of drug-induced parkinsonism was 14.4% (95% CI: 11.0 to 18.0) and it was 12.4% (95% CI: 9.3 to 15.4) for drug-induced akathisia. The result of the final model found out drug-induced parkinsonism was significantly associated with female sex, age, type of antipsychotics, physical illness, and anti-cholinergic medication use. Similarly, female sex, chlorpromazine equivalent doses of 200 to 600 mg, combined treatment of sodium valproate with antipsychotic, and severe khat/Catha edulis use risk level was significantly associated with akathisia.
One of seven patients developed drug-induced parkinsonism and akathisia. Careful patient assessment for drug-induced movement disorders, selection of drugs with minimal side effects, screening patients for physical illness, and psycho-education on substance use should be given top priority.
确定精神疾病患者使用精神药物引起的帕金森病和静坐不能的严重程度和相关因素。
这是一项 2019 年 4 月至 6 月在吉马医疗中心精神病学诊所接受随访治疗的 410 名参与者参与的基于医院的横断面研究。参与者采用系统随机抽样方法招募。使用锥体外系症状评定量表评估药物引起的帕金森病和静坐不能。使用世界卫生组织酒精、吸烟和物质使用参与筛查测试评估物质使用。使用 EpiData 版本 3.1 录入数据，使用统计软件包 22 进行分析。统计学上，调整后的优势比、95%置信区间和 p 值小于或等于 0.05 表示有统计学意义。
受访者的平均年龄为 33.3 岁（SD ± 8.55）。大多数参与者 223 人（54.4%）被诊断为精神分裂症。药物引起的帕金森病的患病率为 14.4%（95%CI：11.0 至 18.0），药物引起的静坐不能的患病率为 12.4%（95%CI：9.3 至 15.4）。最终模型的结果发现，药物引起的帕金森病与女性、年龄、抗精神病药物类型、躯体疾病和抗胆碱能药物使用显著相关。同样，女性、氯丙嗪等效剂量为 200 至 600mg、丙戊酸钠与抗精神病药联合治疗以及重度使用阿拉伯茶/巧茶的风险水平与静坐不能显著相关。
七分之一的患者出现药物引起的帕金森病和静坐不能。应优先考虑对药物引起的运动障碍进行仔细的患者评估、选择副作用最小的药物、对躯体疾病进行筛查以及对物质使用进行心理教育。
