The influence of topography on the cognitive and psychopathological effects of tardive dyskinesia

OBJECTIVE: The purpose of the study was to investigate the influence of the topography of dyskinetic movements on their effect on cognitive impairment and negative symptoms. METHOD: Eighty-four inpatients who satisfied DSM-III-R criteria for schizophrenia were rated for tardive dyskinesia, akathisia, and drug-induced parkinsonism, as well as negative symptoms, with the Scale for the Assessment of Negative Symptoms and for cognitive state with the Mini-Mental State examination. The subjects were then divided into those without tardive dyskinesia (N = 45), those with orofacial dyskinesia (N = 19), and those with limb-truncal dyskinesia (N = 20). Differences among the groups were assessed with multiple analysis of covariance (MANCOVA), with age, akathisia, and drug-induced parkinsonism ratings as the covariates. Post hoc Spjotvoll and Stoline tests were then undertaken. RESULTS: MANCOVA revealed a significant difference among the groups. Post hoc tests showed that the group with limb-truncal dyskinesia had significantly lower scores on the Mini-Mental State Examination and higher scores on the Scale for the Assessment of Negative Symptoms. The group with orofacial dyskinesia was significantly different from the nondyskinetic group only on the total score for the Scale for the Assessment of Negative Symptoms and the attention subscale. There were no significant differences between the dyskinetic groups. CONCLUSIONS: After correction for the important confounding variables of age, akathisia, and drug-induced parkinsonism scores, those with limb- truncal and, to a lesser degree, orofacial dyskinesia differed significantly from nondyskinetic comparison subjects in ratings of cognitive impairment and negative symptoms.