ABSTRACT
OBJECTIVES: We aimed to characterize parkinsonian features and gait performance of psychiatric patients on neuroleptics (PPN) and to compare them to Parkinson's disease (PD) and healthy controls (HC). METHODS: Hospitalized PPN (n = 27) were recruited, examined, and rated for parkinsonian signs according to the motor part of the Movement Disorders Society Unified Parkinson's Disease Rating Scale and performed a 10-m "timed-up-and-go" (TUG) test with a smartphone-based motion capture system attached to their sternum. Gait parameters and mUPDRS scores were compared to those of consecutive age-matched PD patients (n = 18) and HC (n = 27). RESULTS: Psychiatric patients on neuroleptics exhibited parkinsonism (mUPDRS score range: 8-44) but less than that of PD patients (18.2 ± 9.2 vs 29.8 ± 10.3, P = 0.001). TUG times were slower for PPN and PD versus HC (total: 30.6 ± 7.6 seconds vs 30.0 ± 7.3 seconds vs 20.0 ± 3.2 seconds, straight walking: 10.6 ± 2.7 seconds vs 10.6 ± 2.4 seconds vs 6.8 ± 1.2 seconds) (P < 0.001), and cadence and step length were similar among PPN and PD and different from HC as well. Although their gait speed was slower than HC but similar to PD, PPN had lower mediolateral sway (4.3 ± 1.1 cm vs 6.7 ± 2.9 cm vs 6.9 ± 2.9 cm, respectively, P < 0.001) than both. CONCLUSIONS: Parkinsonism is very common in hospitalized PPN, but usually milder than that of PD. It seems that wearable sensor-based technology for assessing gait and balance may present a more sensitive and quantitative tool to detect clinical aspects of neuroleptic-induced parkinsonism than standard clinical ratings.
Subject(s)
Antipsychotic Agents/adverse effects , Gait Analysis/statistics & numerical data , Mental Disorders/complications , Mental Disorders/physiopathology , Parkinson Disease, Secondary/physiopathology , Parkinson Disease/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Antipsychotic Agents/therapeutic use , Case-Control Studies , Female , Gait Analysis/methods , Humans , Inpatients , Male , Mental Disorders/drug therapy , Middle Aged , Monitoring, Ambulatory/methods , Parkinson Disease, Secondary/chemically induced , Parkinson Disease, Secondary/complications , Young AdultABSTRACT
We evaluated the level of adolescent psychiatric patients' knowledge and understanding of their treatment in light of their competency to participate in decision-making processes related to their receiving treatment, and compared the adolescents' levels of understanding and knowledge to those of adult psychiatric patients. The study group consisted of 30 adolescents and 30 adults who were randomly selected from the inpatients of our mental health center. Consenting participants were interviewed and their objective knowledge of psychiatric treatments was evaluated by a specially designed questionnaire. Adolescents knew significantly more about adverse effects of treatment and showed a higher level of comprehensive general knowledge. These data indicate that adolescents are no less knowledgeable than adults and should be regarded as competent partners in the process of therapeutic decision making.
