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Published on: November 21, 2013
A Study on Drug-Induced Tardive Dyskinesia: Orofacial Musculature Involvement and Patient's Awareness
Arunachalam M Anusa1, Rooban Thavarajah2,3, Dinesh Nayak4
1Department of Psychiatry, Affiliated to Sri Balaji Vidyapeeth, Shri Sathya Sai Medical College and Research Institute, Kanchipuram.
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 P≤0.05 as significance.
Results:
The mean of only orofacial features (n = 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 (P≤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.
Insights
Schizophrenia patients on antipsychotics risk tardive dyskinesia (TD). This study links TD orofacial movements to patient stress, aiding dental care for those with TD.
Area of Science:
- Psychiatry
- Neurology
- Dentistry
Background:
- Schizophrenia requires long-term antipsychotic treatment.
- Long-term antipsychotic use can lead to tardive dyskinesia (TD), a movement disorder.
- Abnormal Involuntary Movement Scale (AIMS) measures TD severity.
Purpose of the Study:
- Examine the relationship between TD, orofacial muscle activity, and patient awareness of involuntary movements.
- Inform dentists on providing oral care for schizophrenic patients with TD.
- Highlight the need for physician and dentist awareness of TD for patient management.
Main Methods:
- Analyzed data from 317 patients, with 38.3% showing AIM scores from 2 to 15.
- Utilized descriptive and inferential statistical analysis (SPSS) with P≤0.05 significance.
- Assessed orofacial features, drug history, and AIMS details.
Main Results:
- Mean orofacial feature score was 3.43 ± 2.68 (n=56).
- Tongue (67.54%), jaw (45.61%), and lip/perioral area (23.68%) were most affected orofacial muscles.
- Patient perception of stress related to AIMs in jaw, tongue, limbs, and trunk was significant (P≤0.05).
Conclusions:
- Approximately 1% of the global population with schizophrenia are at risk of developing TD.
- Patients with TD may require specialized orodental care, including prosthodontic and restorative services.
- Physicians and dentists must be aware of TD and its mechanisms for effective patient care.
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