Movement Disorders and Mortality in Severely Mentally Ill Patients: The Curacao Extrapyramidal Syndromes Study XIV
Willems, Anne E; Mentzel, Charlotte L; Bakker, Pieter Roberto; van Os, Jim; Tenback, Diederik E; Gelan, Petra; Daantjes, Erna; Matroos, Glenn E; Hoek, Hans W; van Harten, Peter N
(2022) Schizophrenia bulletin, volume 48, issue 4, pp. 766 - 773
(Article)
Abstract
BACKGROUND AND HYPOTHESIS: There is a substantial gap in life expectancy between patients with severe mental illness (SMI) and the general population and it is important to understand which factors contribute to this difference. Research suggests an association between tardive dyskinesia (TD) and mortality; however, results are inconclusive. In addition,
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studies investigating associations between parkinsonism or akathisia and mortality are rare. We hypothesized that TD would be a risk factor for mortality in patients with SMI. STUDY DESIGN: We studied a cohort of 157 patients diagnosed predominantly with schizophrenia on the former Netherlands Antilles. TD, parkinsonism, and akathisia were assessed with rating scales on eight occasions over a period of 18 years. Twenty-four years after baseline, survival status and if applicable date of death were determined. Associations between movement disorders and survival were analyzed using Cox regression. Sex, age, antipsychotics, antidepressants and benzodiazepines at each measurement occasion were tested as covariates. STUDY RESULTS: Parkinsonism was a significant risk factor with an HR of 1.02 per point on the motor subscale of the Unified Parkinson's Disease Rating Scale (range 0-56). TD and akathisia were not significantly associated with mortality. CONCLUSIONS: Parkinsonism may be an important risk factor for mortality in SMI patients. This finding calls for more follow-up and intervention studies to confirm this finding and to explore whether treatment or prevention of parkinsonism can reduce excess mortality.
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Keywords: Antipsychotic Agents/adverse effects, Basal Ganglia Diseases/chemically induced, Curacao, Dyskinesia, Drug-Induced/diagnosis, Humans, Mentally Ill Persons, Parkinsonian Disorders, Psychomotor Agitation, Syndrome, Tardive Dyskinesia/chemically induced, Tardive dyskinesia, akathisia, life expectancy, parkinsonism, schizophrenia, survival, Psychiatry and Mental health, Journal Article
ISSN: 0586-7614
Publisher: Oxford University Press
Note: Funding Information: The Curacao Extrapyramidal Syndromes Studies were supported by a grant from the NASKHO (National Antilles Foundation for Clinical Higher Education). Publisher Copyright: © 2022 The Author(s) 2022.
(Peer reviewed)