title: Tardive dyskinesia is associated with greater cognitive impairment in schizophrenia.
abstract: OBJECTIVE
  Schizophrenia is a psychiatric disorder diagnosed by the presence of a number of symptoms with cognitive impairment as a core feature. Long-term antipsychotic treatment is often associated with the emergence of tardive dyskinesia (TD) and the presence of TD is linked to cognitive impairment. This study examined the relationship between TD and cognitive deficits in Chinese patients with schizophrenia.
  
  
  METHODS
  We recruited 206 chronic patients with TD (n=102) and without TD (n=104) meeting DSM-IV criteria for schizophrenia and 104 control subjects who were matched on age, gender, and education. All the patients completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Positive and Negative Symptom Scale (PANSS), and the Abnormal Involuntary Movement Scale (AIMS).
  
  
  RESULTS
  The PANSS total score (p=0.01), N subscore (p=0.006), and AIMS total score (p<0.001) were significantly higher in patients with TD compared to patients without TD. Patients with TD scored lower for visuospatial/constructional, attention, and total index scores (all p<0.001) on the RBANS. AIMS orofacial scores were identified as an independent contributor to RBANS total scores and attention index (p<0.05), whereas AIMS limb and truncal scores were an independent determinant to the visuospatial/constructional index of RBANS (p<0.05).
  
  
  CONCLUSIONS
  TD was associated with greater cognitive impairment in patients with schizophrenia compared to those without TD. The orofacial and limb-trunk TD specifically appeared to be a risk factor or contributor to the different aspects of cognitive deficits in schizophrenia. The association between schizophrenia and TD may be explained in part by oxidative stress.
authors.affiliation: School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Schizophrenia Research Institute, Sydney, Australia; Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China.
authors.forename: Jing Qin
authors.initials: JQ
authors.lastname: Wu
authors.forename: Da Chun
authors.initials: DC
authors.lastname: Chen
authors.forename: Mei Hong
authors.initials: MH
authors.lastname: Xiu
authors.forename: Yun Long
authors.initials: YL
authors.lastname: Tan
authors.forename: Fu De
authors.initials: FD
authors.lastname: Yang
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kosten
authors.forename: Xiang Yang
authors.initials: XY
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects*; D044466:Asian People / Q000208:ethnology / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents
keywords: AIMS; ANOVA; Abnormal Involuntary Movement Scale; Assessment of Neuropsychological Status; CLAT; Cognition; MDA; MMSE; Oxidative stress; PANSS; Positive and Negative Symptom Scale; Psychopathology; RBANS; SOD; Schizophrenia; TBARS; TD; Tardive dyskinesia; analysis of variance; conceptual analogy test; malondialdehyde; mini-mental state examination; superoxide dismutase; tardive dyskinesia; thiobarbituric acid reactive substances