Sachdev P
Neuropsychiatric Institute, Prince Henry Hospital, Sydney, Australia.
Acta Psychiatr Scand. 1993 Aug;88(2):98-103. doi: 10.1111/j.1600-0447.1993.tb03421.x.
The objective of this study was to determine the putative risk factors for the development of tardive dystonia (TDt) in contrast with tardive dyskinesia (TD). Fifteen TDt patients seen in the Movement Disorders Clinic were compared with 2 groups of 15 TD controls each. The first control group was drawn from the Clinic and matched with the TDt cases for severity, using degree of dysfunction as the matching variable. The second control group comprised mild TD cases drawn from a separate study of drug-induced movement disorders in chronic schizophrenia and were matched for age and sex with the TDt cases. A number of demographic, treatment-related, diagnosis-related and historical variables suggested in the literature were examined. Most risk factors for TDt that have been suggested by previous studies were not supported. The first control group was significantly older than the TDt cases. The TDt patients had a more frequent past history of acute drug-induced dystonia and of postural tremor prior to the onset of the mental illness, although only the former reached statistical significance. The results suggested that TDt and TD do not differ in most putative risk factors, although the small sample size increases the likelihood of a type II error. It is inconclusive on the role of young age and male sex as risk factors. TDt cases may, however, be individuals vulnerable to the development of dystonia, with neuroleptics probably bringing out such a vulnerability. This finding needs to be examined in larger studies.
本研究的目的是确定迟发性肌张力障碍（TDt）与迟发性运动障碍（TD）相比的潜在危险因素。将在运动障碍诊所就诊的15例TDt患者与两组各15例TD对照进行比较。第一对照组来自该诊所，并以功能障碍程度作为匹配变量，与TDt病例在严重程度上进行匹配。第二对照组由从一项关于慢性精神分裂症药物性运动障碍的单独研究中选取的轻度TD病例组成，并在年龄和性别上与TDt病例进行匹配。对文献中提出的一些人口统计学、治疗相关、诊断相关和病史变量进行了检查。先前研究提出的大多数TDt危险因素未得到证实。第一对照组比TDt病例年龄显著更大。TDt患者在精神疾病发作前有更频繁的急性药物性肌张力障碍和姿势性震颤既往史，尽管只有前者达到统计学意义。结果表明，TDt和TD在大多数潜在危险因素方面没有差异，尽管样本量小增加了II型错误的可能性。关于年轻和男性作为危险因素的作用尚无定论。然而，TDt病例可能是易发生肌张力障碍者，抗精神病药物可能引发了这种易感性。这一发现需要在更大规模的研究中进行检验。
