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Does the degree of smoking effect the severity of tardive dyskinesia? A longitudinal clinical trial

Published online by Cambridge University Press:  16 April 2020

A. Diehl ,
I. Reinhard ,
A. Schmitt ,
K. Mann  and
W.F. Gattaz
A. Diehl*
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Square J 5, 68159Mannheim, Germany
I. Reinhard
Affiliation:
Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Square J 5, 68159Mannheim, Germany
A. Schmitt
Affiliation:
Department for Psychiatry and Psychotherapy, University of Goettingen, von-Siebold-Str. 5, 37075Goettingen, Germany
K. Mann
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Square J 5, 68159Mannheim, Germany
W.F. Gattaz
Affiliation:
Department and Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 05403-010Sao Paulo, Brazil
*
*Corresponding author. Tel.: +49 621 1703 3542; fax: +49 621 1703 3545. E-mail address: alexander.diehl@zi-mannheim.de (A. Diehl) iris.reinhard@zi-mannheim.de (I. Reinhar), aschmit@gwdg.de (A. Schmitt), sucht@zi-mannheim.de (K. Mann), gattaz@usp.br (W. F. Gattaz).
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Abstract

Background

Tardive dyskinesia (TD) is a movement disorder observed after chronic neuroleptic treatment. Smoking is presumed to increase the prevalence of TD. The question of a cause-effect-relationship between smoking and TD, however, remains to be answered. Purpose of this study was to examine the correlation between the degree of smoking and the severity of TD with respect to differences caused by medication.

Method

We examined 60 patients suffering from schizophrenia and TD. We compared a clozapine-treated group with a group treated with typical neuroleptics. Movement disorders were assessed using the Abnormal-Involuntary-Movement-Scale and the technical device digital image processing, providing rater independent information on perioral movements.

Results

We found a strong correlation (.80 < r < .90, always p < .0001) between the degree of smoking and severity of TD. Repeated measurements revealed a positive correlation between changes in cigarette consumption and changes of the severity of TD (p < .0001). Analyses of covariance indicated a significant group-effect with a lower severity of TD in the clozapine-group compared to the typical-neuroleptics-group (p = .010). Interaction-analyses indicated a higher impact of smoking on the severity of TD in the typical-neuroleptics-group compared to the clozapine-group (p = .033).

Conclusion

Concerning a possible cause-effect-relationship between smoking and TD, smoking is more of a general health hazard than neuroleptic exposure in terms of TD.

Keywords

Tardive dyskinesiaMovement disorderSmokingNicotineSchizophreniaAntipsychotics
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 1 , 2009 , pp. 33 - 40
Copyright
Copyright © Elsevier Masson SAS 2009

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