Clinical And Cognitive Study Among Schizophrenia Patients With Tardive Dskinesia

【Objective】 To explore the incidence and risk factors of tardive dyskinesia (TD) among the in-patients with chronic schizophrenia. Neuropsychological tests will be used to measure some of these patients in order to learn whether patients with TD have cognitive impairment. The influence factors of cognitive function will be investigated.【Method】 A self-designed inventory, Positive and Negative Syndrome Scale (PANSS) and Abnormal Involuntary Movement Scale (AIMS) were employed to measure chronic in-patients with schizophrenia met CCMD-2-R criteria. The diagnosis of TD was defined by the criteria of Schooler and Kane's research diagnoses: At least one item of AIMS≥3 or at least two item≥2. TD group include the in-patients met the persistent TD criteria and younger than 65 years (40 patients, 30 male and 10 female). Control group include the same number of in-patients without TD. Two groups were matched for sex, age, education, sorts of antipsychotics. The neuropsychological assessment comprised tests of: Wechsler Adult Intelligence-Revised in China (WAIS-RC), Wechsler Memory Scale (WMS), Wisconsin Card Sort Test (WCST). Descriptives, Crosstabs, Binary Logistic Regression, Group Comparisons, Bivariate Correlate and Liner Regression were performed by SPSS 10.0 in order to test the significance of findings.【Result】 443 in-patients with chronic schizophrenia were investigated. Among them,mean age is 51.1±10.2years , mean course of diseases is 25.1±10.0 years. 96 patients met the criteria of TD. The incidence of tardive dyskinesia is 21.7%. (male 20.3%, female 27.3%, no gender difference.) By the result, younger than 50 years , TD incidence is no gender difference. The incidence of tardive dyskinesia has the significant difference older than 50 years , female is higher than that of male. The risk factors of tardive dyskinesia included sex, age, total scores of PANSS and daily dosage of antipsychotics.80 chronic schizophrenia in-patients were divided into TD group and the control. There are no difference in Verbal IQ, Performance IQ and Full-scale IQ among the two groups. But TD group showed more impairment in MQ (t= 2.121, p=0.037); Digit Span (t= 2.749, p=0.007); Digit Symbol-Coding (t= 1.988, p=0.050); some subtests of long-term memory (Spillikin forward, t= 2.034, p=0.045; Cumulate, t= 2.121, p=0.037), instantaneous memory (Digit recite, t= 2.231, p=0.029) and WCST performs (total trials, t= 3.713, p=0.000; correct, t= 2.544, p=0.013; random error, t= 3.171, p=0.002; categories completed, t= 3.544, p=0.001). Bivariate Correlate show that AIMS is relate to MQ, total trials, correct, random error, categories completed. Education, TD and age show more influence to the cognitive function.【Conclusion】 The incidence of tardive dyskinesia among in-patients with chronic schizophrenia is 21.7%. Old women are more at risk of tardive dyskinesia than men, especially in severe mental state and lower daily drug dosage. Though chronic schizophrenic in-patients with persistent TD showed no global cognitive deficit. But they have poorer memory (especially long-term memory,instantaneous memory and working memory) and WCST performance than that of the control. Education, TD and age show more influence to the cognitive function.