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Tardive dyskinesia: psychiatrists' knowledge and practice

  • Chennattucherry John Joseph (a1), Alan Currie (a2) and Imran Piracha (a3)
Abstract
Aims and method

We surveyed 180 experienced psychiatrists on their training and practice in diagnosing and managing tardive dyskinesia in the current atypical antipsychotic era.

Results

About two-thirds of psychiatrists (n = 124, 69%) responded to the survey. A significant minority had no training in tardive dyskinesia, yet almost everyone recognised the need for formal training in this area. We noted a discrepancy between what respondents believed should be their ideal practice and their reported actual clinical practice. As many as 58% considered that tardive dyskinesia could be a reason for patients to pursue litigation. Many had concerns about prescribing antipsychotics for unlicensed indications, especially for incapacitous patients.

Clinical implications

It is important to recognise current practice and gaps in training, not only to enhance training and patient care but also to mitigate against the risk of litigation.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Chennattucherry John Joseph (john.joseph@ntw.nhs.uk)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 British Medical Association, Royal Pharmaceutical Society of Great Britain. British National Formulary (vol. 59). BMJ Group, Pharmaceutical Press, 2010.
2 National Institute for Clinical Excellence. Guidance on the Use of Newer (Atypical) Antipsychotic Drugs for the Treatment of Schizophrenia (Technology Appraisal Guidance 43). NICE, 2002.
3 National Institute for Clinical Excellence. Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care. Clinical Guideline 1. NICE, 2002.
4 Kane, JM, Woerner, M, Lieberman, J. Tardive dyskinesia: prevalence, incidence and risk factors. Psychopharmacology 1985; 2 (suppl): 72–8.
5 Kane, JM, Woerner, M, Weinhold, P, Wegner, J, Kinon, B, Borenstein, M. Incidence of tardive dyskinesia: five-year data from a prospective study. Psychopharmacol Bull 1984; 20: 387–9.
6 Correll, CU, Leucht, S, Kane, JM. Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies. Am J Psychiatry 2004; 161: 414–25.
7 Correll, CU, Schenk, EM. Tardive dyskinesia and new antipsychotics. Curr Opin Psychiatry 2008; 21: 151–6.
8 Ross, DE, Thomas, M, Booth, M, Weinborn, M. Rate of tardive dyskinesia in hospitalized patients. Am J Psychiatry 2005; 162: 816.
9 De Leon, J. The effect of atypical versus typical antipsychotics on tardive dyskinesia: a naturalistic study. Eur Arch Psychiatry Clin Neurosci 2007; 257: 169–72.
10 Shriqui, CL, Bradwejn, J, Jones, BD. Tardive dyskinesia: legal and preventive aspects. Can J Psychiatry 1990; 35: 576–80.
11 Chaplin, R, Potter, M. Tardive dyskinesia: screening and risk disclosure. Psychiatr Bull 1996; 20: 714–6.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Tardive dyskinesia: psychiatrists' knowledge and practice

  • Chennattucherry John Joseph (a1), Alan Currie (a2) and Imran Piracha (a3)
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