Affective symptoms and family history of affective disorder in patients with tardive dyskinesia

Tardive dyskinesia (TD) represents a serious problem in patients receiving neuroleptic treatment. Besides the known risk factors, a genetically determined vulnerability seems probable. There are controversial findings on the influence of family history of affective disorder and individual history of affective symptomatology [Rush et al., 1982; Richardson et al., 1985; Wegner et al., 1985] on the development of TD. In our study, we examined 288 patients receiving long-term neuroleptic medication for the presence or ab-sence of TD according to RDC criteria. Patients with transient or developed TD and those with a DSM-IV diagnosis other than schizophrenia or schizoaffective disorder were excluded. Family history for affective disorder was assessed by family history method, interviewing the patient and whenever possible a first-degree relative. According to this interview, 27 patients had first-degree relatives with affective disorders. There was no correlation between a family history of affective disorder and the occurrence of TD. No different result was found when schizophrenic and schizoaffective patients were analyzed separately. In addition, we assessed patients for life-time history of affective symptoms by using SADS-LA interview and OPCRIT. While there was no correlation between depressive symptomatology and the occurrence of TD, we found significantly fewer patients with TD to display manic symptoms during life-time than patients never showing TD (P = 0.025). Therefore;, we hypothesize that life-time occurrence of manic symptoms might be considered a protective factor in the development of TD.