Tardive psychopathology

Tardive psychopathology (TP) corresponds to mental changes from chronic neuroleptic exposure, as tardive dyskinesia corresponds to induced movement disorders. TP was prospectively identified in 4 inpatients. Each took neuroleptics more than 3 years, showed good premorbid adjustment or initiative, and met criteria for chronic schizophrenia. Each also had obsessions or compulsions, and apathetic dysphoria, symptoms not previously attributed to TP. Following neuroleptic termination with introduction of lithium and sertraline, each showed atypically rapid disappearance of this psychopathology. The incidence of these features is over 47% (p < 0.05). Some cases of apparent neuroleptic-resistant schizophrenia may be TP.