Prevalence of antipsychotic induced movement disorders among schizophrenia patients at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.
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Date
2019-10
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Introduction: Despite an increasing number of studies identifying the prevalence of
antipsychotic induced movement disorders among schizophrenia patients in high income
countries, limited reports on prevalence of this disorder who were visited health facilities has
been published in Ethiopia among patients who were treated with antipsychotics and all studies
were focused on first generation antipsychotics.
Objective: To determine the prevalence of antipsychotic induced movement disorders, and
associated factors among schizophrenia outpatients at Amanuel Mental Specialized Hospital.
Methods:Data was obtained from the baseline assessment of the clinical trial placebocontrolled
trial of folate with B12 in schizophrenia patients with residual symptoms conducted
from 2014 to 2017 at Amanuel Mental Specialized Hospital. A total of 200 outpatients who were
taking antipsychotics for at least six months or stable at least for six weeks were recruited in the
study. Rating scales were used including Abnormal Involuntary Movement Scale (AIMS) for
Tardive dyskinesia (TD), the Simpson-Angus Rating Scale (SAS) for Antipsychotic-Induced
Parkinsonism and Barnes Rating Scale (BAS) for Akathisia. The minimum threshold value for
the diagnosis of TD was a score of ≥2 on AIMS; for Parkinsonism, SAS mean global score of
≥0.65 and for Akathisia a BAS total score of ≥2. Positive and negative syndrome scale (PANSS)
and scale for assessment of negative symptoms (SANS) were used to measure symptom severity
of schizophrenia as mildly ill 58, moderate 75, marked 95 and severe 116 and at least moderate
one is taken.
Data analysis was conducted using SPSS version 24.0. Frequency and percentage were used to
summarize the data, tables and graphs were used to present the data. Binary logistic regression
was done to see the association between the outcome variable and explanatory variables. The
95% confidence interval was used and significance value P<0.05, odds ratio reference of 1 was
estimated to see the association between outcome variable and explanatory variables.
Results: The overall prevalence of antipsychotic induced movement disorders was 39%.
Prevalence of antipsychotic induced Parkinsonism, tardive dyskinesia, and antipsychotic induced
Akathisia were found to be 28.5%, 19%, and 8% respectively. SANS score of 31-46 [Odds
ratio=3.409, 95%CI=1.044-11.129] and SANS score ≥ 47 [Odds ratio=5.714, 95%CI= 1.48821.948]
were
associated
with
TD
which
shows
markedly
and
severely
ill;
whereas,
being
female
was
found
to
be
protective
[Odds
ratio=
0.346;
95%CI=
0.144-0.832].
Participants
who
had
not
been
working
or
jobless
[Odds
ratio=2.585,
95%CI=
1.079-6.193]
and
having
a
SANS
score
of
≥
47
[Odds ratio=3.000, 95%CI=1.020-8.825] were factors associated with the presence of
antipsychotic induced parkinsonism which shows the association between being severely ill and
presence of antipsychotic induce parkinsonism. PANSS score between 95 and 115 and SANS
score between 31 and 46 had [odds ratio=5.444 and 9.854] were factors associated with the
presence of antipsychotic inducedakathisia.
Conclusions: Thisstudy shows that,aconsiderable number of patients with schizophrenia are
suffering from antipsychotic induced movement disorders. Those who had severe psychotic
symptoms measured by PANSS, SANS, and those who were not working or jobless were found
to be significantly affected by antipsychotic-induced movement disorders.
Recommendation:Screening of patients who are on antipsychotics, early detection and
possible intervention, psycho-education for patients and their family about the side effects,
designing treatment guideline, increasing availability of drugs with minimal side effects are
recommended to reduce these disorders.
Description
Keywords
Schizophrenia patients,antipsychotic induced movement disorders