RESUMO
BACKGROUND: Tardive dyskinesia (TD) remains a significant burden especially among patients taking psychotropic medications, and it is associated with adverse effects that can lead to subjective suffering, stigma, poor compliance to medication, and poor quality of life. However, it is unrecognized and overlooked in clinical settings. So, this study aimed to assess the magnitude of tardive dyskinesia and associated factors among mentally ill patients attending follow-up treatment at Jimma University Medical Center Psychiatry clinic, Jimma, Southwest Ethiopia, 2019. METHODS: Institutional-based cross-sectional study design was conducted in 417 samples. Participants were selected by systematic random sampling techniques. Data were collected by a semi-structured interviewer-administered questionnaire, and the document was reviewed to obtain the patient's profile. Tardive dyskinesia was assessed by using the Extrapyramidal Symptom Rating Scale after informed consent was obtained from respondents. Data entry was done by EpiData version 3.1, and analysis was done by using SPSS 22.0 statistical software. Binary logistic regression and multivariate logistic regression were used to see the association and to identify independent factors at a p-value of <0.05. RESULTS: Prevalence of drug-induced tardive dyskinesia was 15.4% (CI 95%: 12.0, 19.3). Female, age range between 30 and 44 years, having a diagnosis of major depressive disorder with the psychotic feature, taking chlorpromazine equivalent dose Ë600mg, and taking anticholinergic medications were variables positively associated with tardive dyskinesia, whereas cigarette smoking was negatively associated with tardive dyskinesia. CONCLUSION: The prevalence of drug-induced tardive dyskinesia in this study was high. Prescribing medications less than 600mg equivalent dose of chlorpromazine, giving attention for female patients, patients having a diagnosis of major depressive disorder, and reducing giving anticholinergic medications will be important measures for clinicians to reduce the occurrence of tardive dyskinesia.
RESUMO
OBJECTIVE: To determine the magnitude and factors associated with psychotropic drug-induced parkinsonism and akathisia among mentally ill patients. METHODS: A hospital-based cross-sectional study was conducted with a total of 410 participants attending a follow-up treatment service at Jimma Medical Center, a psychiatry clinic from April to June 2019. Participants were recruited using a systematic random sampling method. Drug-induced parkinsonism and akathisia were assessed using the Extra-pyramidal Symptom Rating Scale. Substance use was assessed using the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test. Data entry was done using EpiData version 3.1, and analysis done by the Statistical Package for Social Sciences version 22. Statistically, the significant association was declared by adjusted odds ratio, 95% confidence interval, and p-value less than or equal to 0.05. RESULTS: The mean age of the respondents was 33.3 years (SD ± 8.55). Most of the participants 223 (54.4%) had a diagnosis of schizophrenia. The prevalence of drug-induced parkinsonism was 14.4% (95% CI: 11.0 to 18.0) and it was 12.4% (95% CI: 9.3 to 15.4) for drug-induced akathisia. The result of the final model found out drug-induced parkinsonism was significantly associated with female sex, age, type of antipsychotics, physical illness, and anti-cholinergic medication use. Similarly, female sex, chlorpromazine equivalent doses of 200 to 600 mg, combined treatment of sodium valproate with antipsychotic, and severe khat/Catha edulis use risk level was significantly associated with akathisia. CONCLUSION: One of seven patients developed drug-induced parkinsonism and akathisia. Careful patient assessment for drug-induced movement disorders, selection of drugs with minimal side effects, screening patients for physical illness, and psycho-education on substance use should be given top priority.
