Scales for Antipsychotic-Associated Movement Disorders: Systematic Review, Critique, and Recommendations
Corresponding Author
Davide Martino MD, PhD
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Alberta Children's Research Institute, University of Calgary, Calgary, Alberta, Canada
Correspondence to: Dr. Davide Martino, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; E-mail: [email protected]
Search for more papers by this authorVikram Karnik MD
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Search for more papers by this authorRoongroj Bhidayasiri MD, FRCP, FRCPI
Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
Search for more papers by this authorDeborah A. Hall MD, PhD
Division of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
Search for more papers by this authorRobert A. Hauser MD, MBA
Parkinson's Disease and Movement Disorders Center, Parkinson Foundation Center of Excellence, Department of Neurology, University of South Florida, Tampa, Florida, USA
Search for more papers by this authorAntonella Macerollo MD, PhD
The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
Search for more papers by this authorTamara M. Pringsheim MD
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada
Search for more papers by this authorDaniel Truong MD
The Parkinson's and Movement Disorder Institute, Orange Coast Memorial Medical Center, Fountain Valley, California, USA
Search for more papers by this authorStewart A. Factor DO
Jean and Paul Amos Parkinson's Disease and Movement Disorder Program, Emory University School of Medicine, Atlanta, Georgia, USA
Search for more papers by this authorMatej Skorvanek MD, PhD
Department of Neurology, P.J. Safarik University, Kosice, Slovak Republic
Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic
Search for more papers by this authorAnette Schrag MD, FRCP
Department of Clinical Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
Search for more papers by this authorMembers of the IPMDS Rating Scales Review Committee
Search for more papers by this authorCorresponding Author
Davide Martino MD, PhD
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Alberta Children's Research Institute, University of Calgary, Calgary, Alberta, Canada
Correspondence to: Dr. Davide Martino, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; E-mail: [email protected]
Search for more papers by this authorVikram Karnik MD
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Search for more papers by this authorRoongroj Bhidayasiri MD, FRCP, FRCPI
Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
Search for more papers by this authorDeborah A. Hall MD, PhD
Division of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
Search for more papers by this authorRobert A. Hauser MD, MBA
Parkinson's Disease and Movement Disorders Center, Parkinson Foundation Center of Excellence, Department of Neurology, University of South Florida, Tampa, Florida, USA
Search for more papers by this authorAntonella Macerollo MD, PhD
The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
Search for more papers by this authorTamara M. Pringsheim MD
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada
Search for more papers by this authorDaniel Truong MD
The Parkinson's and Movement Disorder Institute, Orange Coast Memorial Medical Center, Fountain Valley, California, USA
Search for more papers by this authorStewart A. Factor DO
Jean and Paul Amos Parkinson's Disease and Movement Disorder Program, Emory University School of Medicine, Atlanta, Georgia, USA
Search for more papers by this authorMatej Skorvanek MD, PhD
Department of Neurology, P.J. Safarik University, Kosice, Slovak Republic
Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic
Search for more papers by this authorAnette Schrag MD, FRCP
Department of Clinical Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
Search for more papers by this authorMembers of the IPMDS Rating Scales Review Committee
Search for more papers by this authorMembers of the IPMDS Rating Scales Review Committee are listed in the Appendix.
Relevant conflicts of interest/financial disclosures: Nothing to report.
Full financial disclosures and author roles may be found in the online version of this article.
Abstract
Background
Antipsychotic-associated movement disorders remain common and disabling. Their screening and assessment are challenging due to clinical heterogeneity and different use of nomenclature between psychiatrists and neurologists.
Objective
An International Parkinson and Movement Disorder Society subcommittee aimed to rate psychometric quality of severity and screening instruments for antipsychotic-associated movement disorders.
Methods
Following the methodology adopted by previous International Parkinson and Movement Disorders Society subcommittee papers, instruments for antipsychotic-associated movement disorders were reviewed, applying a classification as “recommended,” “recommended with caveats,” “suggested,” or “listed.”
Results
Our review identified 23 instruments. The highest grade of recommendation reached is “recommended with caveats,” assigned to seven severity rating instruments (Extrapyramidal Symptoms Rating Scale, Barnes Akathisia Rating Scale, Abnormal Involuntary Movements Scale, Drug-Induced Extra-Pyramidal Symptoms Scale, Maryland Psychiatric Research Centre involuntary movements scale, Simpson Angus Scale, and Matson Evaluation of Drug Side effects). Only three of these seven (Drug-Induced Extra-Pyramidal Symptoms Scale, Maryland Psychiatric Research Centre, Matson Evaluation of Drug Side effects) were also screening instruments. Their main caveats are insufficient demonstration of psychometric properties (internal consistency, skewing, responsiveness to change) and long duration of administration. Eight “suggested” instruments did not meet requirements for the “recommended” grade also because of insufficient psychometric validation. Other limitations shared by several instruments are lack of comprehensiveness in assessing the spectrum of antipsychotic-associated movement disorders and ambiguous nomenclature.
Conclusions
The high number of instruments “recommended with caveats” does not support the need for developing new instruments for antipsychotic-associated movement disorders. However, addressing the caveats with new psychometric studies and revising existing instruments to improve the clarity of their nomenclature are recommended next steps. © 2023 International Parkinson and Movement Disorder Society.
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| mds29392-sup-0001-supinfo.docxWord 2007 document , 75 KB | Data S1. Supporting Information |
| mds29392-sup-0002-TableS1.docxWord 2007 document , 19.2 KB | Table S1. Search strategies used for each individual search engine. |
| mds29392-sup-0003-TableS2.docxWord 2007 document , 19.7 KB | Table S2. Psychometric properties of rating instruments for antipsychotic-associated movement disorders that received the ‘listed’ recommendation. |
| mds29392-sup-0004-TableS3.docxWord 2007 document , 22.3 KB | Table S3. Phenomena assessed, time of administration, and clinical utility of rating instruments for antipsychotic-associated movement disorders that received the ‘listed’ recommendations. |
| mds29392-sup-0005-TableS4.docxWord 2007 document , 17.5 KB | Table S4. Nomenclature of movement disorders classically used by movement disorders specialists (adapted from Fahn S. Classification of movement disorders. Mov Disord. 2011 May;26 (6):947–957). |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1Widschwendter CG, Hofer A. Antipsychotic-induced tardive dyskinesia: update on epidemiology and management. Curr Opin Psychiatry 2019; 32(3): 179–184.
- 2Billnitzer A, Jankovic J. Current management of Tics and Tourette syndrome: behavioral, pharmacologic, and surgical treatments. Neurotherapeutics 2020; 17(4): 1681–1693.
- 3Friedman JH. Tardive syndromes. Continuum (Minneap Minn) 2019; 25(4): 1081–1098.
- 4Rekhi G, Tay J, Lee J. Impact of drug-induced parkinsonism and tardive dyskinesia on health-related quality of life in schizophrenia. J Psychopharmacol 2022; 36(2): 183–190. https://doi.org/10.1177/02698811211055812
- 5Kelly M, Dornan T, Pringsheim T. The lesser of two evils: a qualitative study of quetiapine prescribing by family physicians. CMAJ Open 2018; 6(2): E191–E196.
- 6Cloud LJ, Zutshi D, Factor SA. Tardive dyskinesia: therapeutic options for an increasingly common disorder. Neurotherapeutics 2014; 11(1): 166–176.
- 7Ali T, Sisay M, Tariku M, Mekuria AN, Desalew A. Antipsychotic-induced extrapyramidal side effects: a systematic review and meta-analysis of observational studies. PLoS One 2021; 16(9):e0257129.
- 8Carbon M, Hsieh CH, Kane JM, Correll CU. Tardive dyskinesia prevalence in the period of second-generation antipsychotic use: a meta-analysis. J Clin Psychiatry 2017; 78(3): e264–e278.
- 9Hauser RA, Meyer JM, Factor SA, et al. Differentiating tardive dyskinesia: a video-based review of antipsychotic-induced movement disorders in clinical practice. CNS Spectr 2022; 27(2): 208–217.
- 10Factor SA, Burkhard PR, Caroff S, Friedman JH, Marras C, Tinazzi M, Comella CL. Recent developments in drug-induced movement disorders: a mixed picture. Lancet Neurol 2019; 18(9): 880–890.
- 11Martino D, Karnik V, Osland S, Barnes TRE, Pringsheim TM. Movement disorders associated with antipsychotic medication in people with schizophrenia: an overview of Cochrane reviews and meta-analysis. Can J Psychiatry 2018; 63(11): 706743718777392.
- 12Factor SA. Management of tardive syndrome: medications and surgical treatments. Neurotherapeutics 2020; 17(4): 1694–1712.
- 13Bhidayasiri R, Kane JM, Frei KP, et al. Expanding phenomenologic heterogeneity of tardive syndromes: time for an updated assessment tool. Parkinsonism Relat Disord 2020; 77: 141–145.
- 14Mokkink LB, Terwee CB, Knol DL, et al. The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol 2010; 10: 22.
- 15Chouinard G. The extrapyramidal symptoms rating scale. Can J Neurol Sci 1980; 7: 233–244.
- 16Barnes TR. A rating scale for drug-induced akathisia. Br J Psychiatry 1989; 154: 672–676.
- 17Lane RD, Glazer WM, Hansen TE, Berman WH, Kramer SI. Assessment of tardive dyskinesia using the abnormal involuntary movement scale. J Nerv Ment Dis 1985; 173(6): 353–357.
- 18Inada T. Evaluation and Diagnosis of Drug-Induced Extrapyramidal Symptoms: Commentary on the DIEPSS and Guide to its Usage. Tokyo: Seiwa Shoten Publishers; 1996.
- 19Cassady SL, Thaker GK, Summerfelt A, Tamminga CA. The Maryland psychiatric research center scale and the characterization of involuntary movements. Psychiatry Res 1997; 70(1): 21–37.
- 20Simpson GM, Angus JW. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl 1970; 212: 11–19.
- 21Matson JL, Mayville EA, Bielecki J, Barnes WH, Bamburg JW, Baglio CS. Reliability of the Matson evaluation of drug side effects scale (MEDS). Res Dev Disabil 1998; 19(6): 501–506.
- 22Sprague RL, Kalachnik JE, Slaw KM. Psychometric properties of the dyskinesia identification system: condensed user scale (DISCUS). Ment Retard 1989; 27(3): 141–148.
- 23Day JC, Wood G, Dewey M, Bentall RP. A self-rating scale for measuring neuroleptic side-effects. Validation in a group of schizophrenic patients. Br J Psychiatry 1995; 166(5): 650–653.
- 24Gerlach J, Korsgaard S, Clemmesen P, et al. The St. Hans rating scale for extrapyramidal syndromes: reliability and validity. Acta Psychiatr Scand 1993; 87(4): 244–252.
- 25Waddell L, Taylor M. A new self-rating scale for detecting atypical or second-generation antipsychotic side effects. J Psychopharmacol 2008; 22(3): 238–243.
- 26Loonen AJ, Doorschot CH, van Hemert DA, Oostelbos MC, Sijben AE. The schedule for the assessment of drug-induced movement disorders (SADIMoD): test-retest reliability and concurrent validity. Int J Neuropsychopharmacol 2000; 3(4): 285–296.
- 27Mazure CM, Cellar JS, Bowers MB Jr, Nelson JC, Takeshita J, Zigun B. Assessment of extrapyramidal symptoms during acute neuroleptic treatment. J Clin Psychiatry 1995; 56(3): 94–100.
- 28Frei K, Truong DD, Fahn S, Jankovic J, Hauser RA. The nosology of tardive syndromes. J Neurol Sci 2018; 389: 10–16.
- 29Musco S, Ruekert L, Myers J, Anderson D, Welling M, Cunningham EA. Characteristics of patients experiencing extrapyramidal symptoms or other movement disorders related to dopamine receptor blocking agent therapy. J Clin Psychopharmacol 2019; 39(4): 336–343.
- 30Remington G, Hahn MK, Agarwal SM, Chintoh A, Agid O. Schizophrenia: antipsychotics and drug development. Behav Brain Res 2021; 414:113507.
- 31Lenze EJ, Mulsant BH, Blumberger DM, et al. Efficacy, safety, and tolerability of augmentation pharmacotherapy with aripiprazole for treatment-resistant depression in late life: a randomised, double-blind, placebo-controlled trial. Lancet 2015; 386(10011): 2404–2412.
- 32Chouinard G, Jones B, Remington G, et al. A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients. J Clin Psychopharmacol 1993; 13: 25–40.
- 33Anderson KE, Stamler D, Davis MD, et al. Deutetrabenazine for treatment of involuntary movements in patients with tardive dyskinesia (AIM-TD): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Psychiatry 2017; 4(8): 595–604.
- 34Hauser RA, Factor SA, Marder SR, et al. KINECT 3: a phase 3 randomized, double-blind, placebo-controlled trial of Valbenazine for tardive dyskinesia. Am J Psychiatry 2017; 174(5): 476–484.
- 35Stacy M, Sajatovic M, Kane JM, Cutler AJ, Liang GS, O'Brien CF, Correll CU. Abnormal involuntary movement scale in tardive dyskinesia: minimal clinically important difference. Mov Disord 2019; 34(8): 1203–1209.
- 36Hauser RA, Barkay H, Wilhelm A, Wieman M, Savola JM, Gordon MF. Minimal clinically important change in abnormal involuntary movement scale score in tardive dyskinesia as assessed in pivotal trials of deutetrabenazine. Parkinsonism Relat Disord 2022; 97: 47–51.
- 37Fahn S. Classification of movement disorders. Mov Disord 2011; 26(6): 947–957.
- 38Truong DD, Frei K. Setting the record straight: the nosology of tardive syndromes. Parkinsonism Relat Disord 2019; 59: 146–150.
- 39Burke RE, Fahn S, Marsden CD, Bressman SB, Moskowitz C, Friedman J. Validity and reliability of a rating scale for the primary torsion dystonias. Neurology 1985; 35(1): 73–77.
- 40Movement Disorder Society task force on rating scales for Parkinson's disease. The unified Parkinson's disease rating scale (UPDRS): status and recommendations. Mov Disord 2003; 18(7): 738–750.
- 41Haddad PM, Fleischhacker WW, Peuskens J, et al. SMARTS (systematic monitoring of adverse events related to TreatmentS): the development of a pragmatic patient-completed checklist to assess antipsychotic drug side effects. Ther Adv Psychopharmacol 2014; 4(1): 15–21.
- 42Balint B, Killaspy H, Marston L, et al. Development and psychometric assessment of a nurse-administered screening tool for movement disorders in psychosis. BJPsych Open 2018; 4(5): 404–410.
- 43Friedman JH. Movement disorders induced by psychiatric drugs that do not block dopamine receptors. Parkinsonism Relat Disord 2020; 79: 60–64.
- 44Ondo W, Hashem V, LeWitt PA, et al. Comparison of the Fahn-Tolosa-Marin clinical rating scale and the essential tremor rating assessment scale. Mov Disord Clin Pract 2017; 23(5): 60–65.
