Tardive dyskinesia associated with higher mortality in psychiatric patients: results of a meta-analysis of seven independent studies.
This article reports a meta-analysis of seven independent studies on the association of tardive dyskinesia with all-cause mortality in psychiatric patients. Most of the studies included provide either small sample sizes or follow-up periods too short to reach a substantive conclusion on their own. In the meta-analysis, the overall odds ratio (OR) was significant when calculated either by the fixed-effects model (OR = 1.4, 95% confidence interval [CI] = 1.2-1.7, p < 0.005) or the random-effects model (OR = 1.4, 95% CI = 1.1-1.8, p < 0.005). There was no overall heterogeneity (Q test = 8.1, df = 7,p = 0.32). The overall estimate changed within study designs (OR = 1.4,p = 0.002 in three prospective controlled studies; OR = 2.2, p = 0.02 in two prospective uncontrolled studies; and OR = 0.9, p = 0.80 in two retrospective controlled studies). It was modified upward when the two most influential studies (one prospective and one retrospective) were removed from the overview (OR = 2.2, 95% CI = 1.4-3.5,p = 0.001; Q test = 0.81, df = 4,p = 0.94). The conclusion of the meta-analysis was that tardive dyskinesia must be considered a weak risk factor in terms of mortality. It remains to be elucidated whether it is a risk factor on its own or just a surrogate for any unknown organic liability.
Ballesteros
J
J
Department of Neuroscience, University of the Basque Country, Leioa, Vizcaya, Spain. onpbaroj@lg.ehu.es
González-Pinto
A
A
Bulbena
A
A
D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002423:Cause of Death; D004409:Dyskinesia, Drug-Induced / Q000401:mortality*; D005500:Follow-Up Studies; D006801:Humans; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000401:mortality; D012307:Risk Factors; D016019:Survival Analysis
D014150:Antipsychotic Agents