Worsening of psychosis in schizophrenia is longitudinally associated with tardive dyskinesia in the European Schizophrenia Outpatient Health Outcomes study

Objective: The objective of the study was to examine if worsening of psychosis predicts the emergence of tardive dyskinesia (TD).Method: Global measures of TD and Clinical Global Impression (CGI) overall symptom severity score were rated in 4 assessments in 12 months. In a risk set free of TD at baseline, associations between TD onset and change in CGI scores were assessed using Cox proportional hazard regression.Results: A total of 8620 patients yielded 23 565 follow-up observations, 8.8% of which represented a worsening in CGI overall symptom severity relative to the previous observation, yielding an incidence of TD of 5.2%, compared with 2.7% in observations without worsening of psychopathology (rate ratio, 1.9; 95% confidence interval, 1.3-2.7). Incidence of TD was longitudinally associated with a worsening of the CGI overall symptom severity in the months preceding TD onset (adjusted hazard ratio over 6 levels of CGI score, 1.3; 95% confidence interval, 1.1-1.4).Conclusion: Worsening in overall psychopathology in schizophrenia is longitudinally associated with the emergence of TD as measured by CGI overall symptom severity. (C) 2007 Published by Elsevier Inc.