Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-06-01T14:39:45.677Z Has data issue: false hasContentIssue false

Cognitive impairment, clinical course and treatment history in out-patients with bipolar affective disorder: relationship to tardive dyskinesia

Published online by Cambridge University Press:  09 July 2009

John L. Waddington*
Affiliation:
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland; Depression and Manic-Depression Research Unit, St Patrick's Hospital; and Dublin Institute of Technology, Dublin, Ireland
Katherine Brown
Affiliation:
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland; Depression and Manic-Depression Research Unit, St Patrick's Hospital; and Dublin Institute of Technology, Dublin, Ireland
Jane O'Neill
Affiliation:
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland; Depression and Manic-Depression Research Unit, St Patrick's Hospital; and Dublin Institute of Technology, Dublin, Ireland
Patrick McKeon
Affiliation:
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland; Depression and Manic-Depression Research Unit, St Patrick's Hospital; and Dublin Institute of Technology, Dublin, Ireland
Anthony Kinsella
Affiliation:
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland; Depression and Manic-Depression Research Unit, St Patrick's Hospital; and Dublin Institute of Technology, Dublin, Ireland
*
1Address for correspondence: Dr John L. Waddington, Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland.

Synopsis

Clinical, neuropsychological and psychopharmacological characteristics were investigated for their ability to distinguish individuals with and without involuntary movements (tardive dyskinesia), among a population of 40 out-patients with bipolar affective disorder and a history of exposure to neuroleptics and lithium. Impaired performance on a test of cognitive flexibility bore the primary association with both the presence and the severity of involuntary movements. The additional relationships identified emphasized further that individual vulnerability to involuntary movements appeared to be associated not with greater duration or dosage of treatment, but with features of the bipolar illness, including number and type of affective episodes, for which that treatment was prescribed.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd edn). American Psychiatric Association. Washington, DC.Google Scholar
Davis, J. M. (1976). Comparative doses and costs of antipsychotic medication. Archives of General Psychiatry 33, 858861.CrossRefGoogle ScholarPubMed
DeWolfe, A. S., Ryan, J. J. & Wolf, M. E. (1988). Cognitive sequelae of lardive dyskinesia. Journal of Nervous and Mental Disease 176, 270274.Google Scholar
Fleiss, J. L., Williams, J. B. W. & Dubro, A. F. (1986). Logistic regression analysis of psychiatric data. Journal of Psychiatric Research 20, 195209.CrossRefGoogle ScholarPubMed
Gardos, G. & Casey, D. E. (1984). Tardive Dyskmesia and Affective Disorders. American Psychiatric Press: Washington, DC.Google Scholar
Glazer, W. M., Morgenstern, H., Niedzwiecki, D. & Hughes, J. (1988). Heterogeneity of tardive dyskinesia: a multivariate analysis British Journal of Psychiatry 152, 253259.CrossRefGoogle Scholar
Hoff, A. L., Shukla, S., Cook, B. L., Aronson, T. A., Olio, C. L. & Pass, H. L. (1988). Cognitive function in manics with associated neurological factors. Journal of Affective Disorders 14, 251255.CrossRefGoogle Scholar
Kane, J. M & Smith, J. M. (1982). Tardive dyskinesia: prevalence and risk factors, 1959–1979. Archives of General Psychiatry 39, 473481.Google Scholar
Kane, J. M., Woerner, M., Borenstein, M., Wegner, J. T. & Lieberman, J. (1986). Integrating incidence and prevalence of tardive dyskinesia. Psychopharmacology Bulletin 22, 254258.Google Scholar
Mukherjee, S., Rosen, A. M., Caracci, G. & Shukla, S. (1986). Persistent tardive dyskinesia in bipolar patients. Archives of General Psychiatry 43, 342346.Google Scholar
National Institute of Mental Health (1976). In Early Clinical Drug Evaluation Unit Assessment Manual (ed. Guy, W.), pp. 534537. US Department of Health and Human Services: Rockville.Google Scholar
Post, R. M., Rubinow, D. R. & Ballenger, J. C. (1986). Conditioning and sensitisation in the longitudinal course of affective illness. British Journal of Psychiatry 149, 191201.CrossRefGoogle ScholarPubMed
Reitan, R. M. (1955). The relation of the trail making test to organic brain damage. Journal of Consulting Psychology 19, 393394.Google Scholar
Reitan, R. M. (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills 8, 271276.CrossRefGoogle Scholar
Schooler, N. R. & Kane, J. M. (1982). Research diagnoses for tardive dyskinesia. Archives of General Psychiatry 39, 486487.Google Scholar
Sorokin, J. E., Giordani, B., Mohs, R. C., Losonczy, M. F., Davidson, M., Siever, L. J., Ryan, T. A. & Davis, K. L. (1988). Memory impairment in schizophrenic patients with tardive dyskinesia. Biological Psychiatry 23, 129135.Google Scholar
Waddington, J. L. (1987). Tardive dyskinesia in schizophrenia and other disorders associations with ageing, cognitive dysfunction and structural brain pathology in relation to neuroleptic exposure. Human Psychopharmacology 2, 1122.CrossRefGoogle Scholar
Waddington, J. L. & Youssef, H. A. (1986 a). Late onset involuntary movements in chronic schizophrenia: relationship of tardive dyskinesia to intellectual impairment and negative symptoms. British Journal of Psychiatry 149, 616620.Google Scholar
Waddington, J. L. & Youssef, H. A. (1986 b). An unusual cluster of tardive dyskinesia in schizophrenia: association with cognitive dysfunction and negative symptoms. American Journal of Psychiatry 143, 11621165.Google Scholar
Waddington, J. L. & Youssef, H A. (1986 c). Involuntary movements and cognitive dysfunction in late onset schizophrenic outpatients. Irish Medical Journal 79, 347350.Google Scholar
Waddington, J. L. & Youssef, H. A. (1988). Tardive dyskinesia in bipolar affective disorder: aging, cognitive dysfunction, course of illness and exposure to neuroleptics and lithium. American Journal of Psychiatry 145, 613616.Google Scholar
Waddington, J. L., Youssef, H. A., Dolphin, C. & Kinsella, A. (1987). Cognitive dysfunction, negative symptoms and tardive dyskinesia in schizophrenia: their association in relation to topography of involuntary movements and criterion of their abnormality. Archives of General Psychiatry 44, 907912.CrossRefGoogle ScholarPubMed
Wade, J. B., Taylor, M. A., Kasprisin, A., Rosenberg, S. & Fiducia, D (1987). Tardive dyskinesia and cognitive impairment. Biological Psychiatry 22, 393395.Google Scholar
Wegner, J. T., Catalano, F., Gibralter, J. & Kane, J. M. (1985). Schizophrenics with tardive dyskinesia: neuropsychological deficit and family psychopathology. Archives of General Psychiatry 42, 860865.Google Scholar
Wehr, T. A. & Goodwin, F. K. (1987). Can antidepressants cause mania and worsen the course of affective illness? American Journal of Psychiatry 144, 14031411.Google ScholarPubMed
Wolf, M. E., Ryan, J. J. & Mosnaim, A. D. (1983). Cognitive functions in tardive dyskinesia. Psychological Medicine 13, 671674.CrossRefGoogle ScholarPubMed
Yassa, R & Schwartz, G. (1984). Depression as a predictor in the development of tardive dyskinesia. Biological Psychiatry 19, 441444.Google Scholar
Yassa, R., Nair, V. & Schwartz, G. (1984). Tardive dyskinesia and the primary psychiatric diagnosis. Psychosomatics 25, 135138.Google Scholar
Yassa, R., Camille, Y. & Belzile, L. (1987). Tardive dyskinesia in the course of antidepressant therapy: a prevalence study and review of the literature. Journal of Clinical Psychopharmacology 7, 243246.Google Scholar
Youssef, H. A. & Waddington, J. L. (1988 a). Primitive (developmental) reflexes and diffuse cerebral dysfunction in schizophrenia and bipolar affective disorder; over-representation in patients with tardive dyskinesia. Biological Psychiatry 23, 791796.Google Scholar
Youssef, H. A. & Waddington, J. L. (1988 b). Involuntary orofacial movements in hospitalised patients with mental handicap or epilepsy relationship to developmental/intellectual deficit and presence or absence of long-term exposure to neuroleptics. Journal of Neurology, Neurosurgery and Psychiatry 51, 863865.Google Scholar