Objective: To examine relationship of tardive dyskinesia (TD) with psychopathology, insight into illness and cognitive impairment in older people with psychosis.
Design: Cross-sectional (sub-analysis of a study examining ‘Coping strategies in older people with psychosis’)
Materials and Methods: Convenience sample of 46 patients, aged 65 or over, diagnosed to have psychotic illness were recruited from old age psychiatry services in Manchester, UK. Study assessments included Positive and Negative Symptoms Score (PANSS), Birchwood Insight Scale (BIS) and Mini-Mental State Examination (MMSE).
Results: Age: 73.5 (+/-6.7) years. Male/female: 8/37. Diagnosis: Schizophrenia 36, Schizoaffective Disorder 6, Delusional Disorder 4. Duration of illness: 30.6 (+/- 14.4) years. TD (Schooler & Kane, 1982) was present in 19 (41%), Orofacial dyskinesia (Waddington & Youssef, 1996) 16 (35%). Patients with TD scored higher on positive (16.1 vs 11.5, p=0.002), negative (18.8 vs 14.5, p=0.025) and total (69.2 vs 56.5, p=0.025) PANSS. They had lower scores on BIS and MMSE but the difference did not reach statistical significance (p=0.097 & p=0.167. Patients with orofacial dyskinesia had lower scores on MMSE compared to rest (22.4 vs 25.2, p=0.055).
Conclusion: TD seems to be associated with increased psychopathology (both positive and negative symptoms) and reduced insight while orofacial dyskinesia may be associated with cognitive impairment. Results will be discussed in the context of available literature, limitations of the study and further analysis.
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