Haloperidol 혹은 Chlorpromazine을 투여 중인 정신분열병 환자에 있어서 가성 정좌불능증의 유병율과 임상적 특성
Prevalence and Clinical Characteristics of Pseudoakathisia in Schizophrenic Patients Taking Haloperidol or Chlorpromazine
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Objectives：The purpose of this study was to investigate the prevalence and clinical characteristics of pseudoakathisia in schizophrenic in-patients who were receiving stable dosage of haloperidol or chlorpromazine. In particular, we sought to examine the relationship of pseudoakathisia to parkinsonism and tardive dyskinesia(TD). Methods：The subjects were 110 in-patients aged between 18 and 60. The diagnosis and subtypes of akathisia were made according to the criteria of Barnes Akathisia Rating Scale(BARS). Pseudoakathisia was diagnosed if the score on the subjective awareness of restlessness item of the BARS was 0 and the score on the objective motor manifestation item of the BARS was 1 or more. Drug-induced parkinsonism and TD were evaluated using the Simpson- Angus Scale(SAS) and the Abnormal Involuntary Movement Scale(AIMS), respectively. Schizophrenic symptoms were assessed using the Manchester Scale. The prevalence of pseudoakathisia was examined, and the clinical variables were compared among the pseudoakathisia, true akathisia, and non-akathisia groups. The correlations between the symptomatology of akathisia and the other extrapyramidal motor signs were also evaluated. Results：The prevalence of pseudoakathisia was found to be 8.2%(9/110). Three out of 9 patients with pseudoakathisia had both parkinsonism and TD, and 4 patients had only pseudoakathisia without being accompanied by other movement disorders. The demographic variables and the Manchester Scale score were not different among the groups. No significant group differences were found regarding the concurrence rate of parkinsonism or TD. In correlation analysis, BARS motor manifestation score was significantly correlated with AIMS total and limb-truncal dyskinesia scores, but not with AIMS orofacial dyskinesia score and SAS total score. Subjective restlessness score of BARS was significantly correlated with SAS total score but not with AIMS scores. Conclusion：The results of the present study showed that the prevalence of pseudoakathisia in chronic schizophrenic in-patients receiving haloperidol or chlorpromazine was 8.2%. In clinical characteristics, pseudoakathisia with both parkinsonism and TD may exist. The relationship between pseudoakathisia and TD may be relatively limited. Further studies are required to elucidate more detailed characteristics of pseudoakathisia, and to examine its relationship with various clinical variables.
Abstract
Objectives：The purpose of this study was to investigate the prevalence and clinical characteristics of pseudoakathisia in schizophrenic in-patients who were receiving stable dosage of haloperidol or chlorpromazine. In particular, we sought to examine the relationship of pseudoakathisia to parkinsonism and tardive dyskinesia(TD). Methods：The subjects were 110 in-patients aged between 18 and 60. The diagnosis and subtypes of akathisia were made according to the criteria of Barnes Akathisia Rating Scale(BARS). Pseudoakathisia was diagnosed if the score on the subjective awareness of restlessness item of the BARS was 0 and the score on the objective motor manifestation item of the BARS was 1 or more. Drug-induced parkinsonism and TD were evaluated using the Simpson- Angus Scale(SAS) and the Abnormal Involuntary Movement Scale(AIMS), respectively. Schizophrenic symptoms were assessed using the Manchester Scale. The prevalence of pseudoakathisia was examined, and the clinical variables were compared among the pseudoakathisia, true akathisia, and non-akathisia groups. The correlations between the symptomatology of akathisia and the other extrapyramidal motor signs were also evaluated. Results：The prevalence of pseudoakathisia was found to be 8.2%(9/110). Three out of 9 patients with pseudoakathisia had both parkinsonism and TD, and 4 patients had only pseudoakathisia without being accompanied by other movement disorders. The demographic variables and the Manchester Scale score were not different among the groups. No significant group differences were found regarding the concurrence rate of parkinsonism or TD. In correlation analysis, BARS motor manifestation score was significantly correlated with AIMS total and limb-truncal dyskinesia scores, but not with AIMS orofacial dyskinesia score and SAS total score. Subjective restlessness score of BARS was significantly correlated with SAS total score but not with AIMS scores. Conclusion：The results of the present study showed that the prevalence of pseudoakathisia in chronic schizophrenic in-patients receiving haloperidol or chlorpromazine was 8.2%. In clinical characteristics, pseudoakathisia with both parkinsonism and TD may exist. The relationship between pseudoakathisia and TD may be relatively limited. Further studies are required to elucidate more detailed characteristics of pseudoakathisia, and to examine its relationship with various clinical variables.
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