Kumsa Assefa, Girma Shimelis, Alemu Bezaye, Agenagnew Liyew
Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia.
Clin Pharmacol. 2020 Dec 1;12:179-187. doi: 10.2147/CPAA.S285585. eCollection 2020.
Tardive dyskinesia (TD) remains a significant burden especially among patients taking psychotropic medications, and it is associated with adverse effects that can lead to subjective suffering, stigma, poor compliance to medication, and poor quality of life. However, it is unrecognized and overlooked in clinical settings. So, this study aimed to assess the magnitude of tardive dyskinesia and associated factors among mentally ill patients attending follow-up treatment at Jimma University Medical Center Psychiatry clinic, Jimma, Southwest Ethiopia, 2019.
Institutional-based cross-sectional study design was conducted in 417 samples. Participants were selected by systematic random sampling techniques. Data were collected by a semi-structured interviewer-administered questionnaire, and the document was reviewed to obtain the patient's profile. Tardive dyskinesia was assessed by using the Extrapyramidal Symptom Rating Scale after informed consent was obtained from respondents. Data entry was done by EpiData version 3.1, and analysis was done by using SPSS 22.0 statistical software. Binary logistic regression and multivariate logistic regression were used to see the association and to identify independent factors at a p-value of <0.05.
Prevalence of drug-induced tardive dyskinesia was 15.4% (CI 95%: 12.0, 19.3). Female, age range between 30 and 44 years, having a diagnosis of major depressive disorder with the psychotic feature, taking chlorpromazine equivalent dose ˃600mg, and taking anticholinergic medications were variables positively associated with tardive dyskinesia, whereas cigarette smoking was negatively associated with tardive dyskinesia.
The prevalence of drug-induced tardive dyskinesia in this study was high. Prescribing medications less than 600mg equivalent dose of chlorpromazine, giving attention for female patients, patients having a diagnosis of major depressive disorder, and reducing giving anticholinergic medications will be important measures for clinicians to reduce the occurrence of tardive dyskinesia.
迟发性运动障碍（TD）仍然是一个重大负担，尤其是在服用精神药物的患者中，它与不良反应相关，可导致主观痛苦、污名化、药物依从性差和生活质量低下。然而，它在临床环境中未被识别和忽视。因此，本研究旨在评估2019年在埃塞俄比亚西南部吉马市吉马大学医学中心精神病诊所接受随访治疗的精神病患者中迟发性运动障碍的严重程度及相关因素。
在417个样本中进行基于机构的横断面研究设计。参与者通过系统随机抽样技术选取。数据通过半结构化访谈者 administered 问卷收集，并查阅文件以获取患者资料。在获得受访者知情同意后，使用锥体外系症状评定量表评估迟发性运动障碍。数据录入使用EpiData 3.1版本，分析使用SPSS 22.0统计软件。二元逻辑回归和多元逻辑回归用于观察关联并识别p值<0.05的独立因素。
药物性迟发性运动障碍的患病率为15.4%（95%CI：12.0，19.3）。女性、年龄在30至44岁之间、诊断为伴有精神病性特征的重度抑郁症、服用氯丙嗪等效剂量>600mg以及服用抗胆碱能药物是与迟发性运动障碍呈正相关的变量，而吸烟与迟发性运动障碍呈负相关。
本研究中药物性迟发性运动障碍的患病率较高。开具低于600mg等效剂量氯丙嗪的药物、关注女性患者、诊断为重度抑郁症的患者以及减少抗胆碱能药物的使用将是临床医生减少迟发性运动障碍发生的重要措施。
