Tardive Dyskinesia and Subtyping of Schizophrenia
The history of psychiatry, especially that of the “functional psychoses,” is replete with systems of classification proposed by “splitters” and “lumpers.” Kraepelin (1907) split manic depressive illness from dementia precox and lumped under the latter category different conditions described by Morel, Kahl-baum, and Hecker. Bleuler (1911) clearly recognized the heterogeneous nature of schizophrenia and split the syndrome into paranoid, catatonic, simple and hebephrenic subtypes. Since then a number of attempts have been made to subdivide the schizophrenic syndrome into rational subgroups. Most of the traditional classifications have been based on “naturalistic” variables such as symptomatology and course. In recent years, several investigators have suggested clinical utility and potential biological validity of subtyping disorders according to patterns of response to “extraneous” variables, such as drug treatment (Klein, 1965). Since the most effective treatment of chronic schizophrenia is neuroleptic administration, it would seem logical to attempt subdividing schizophrenic patients on the basis of their response to neuroleptic treatment. While therapeutic response to neuroleptics has been used to characterize patient subgroups (neuroleptic responders versus nonresponders), we believe that it might also be useful to subtype neuroleptic-treated chronic schizophrenic patients according to the development of tardive dyskinesia (TD). In a recent study we classified schizophrenic patients into different subgroups using a number of different dimensions (Jeste et al., 1982). This paper deals with the study using the TD dimension.
KeywordsSchizophrenic Patient Tardive Dyskinesia Brief Psychiatric Rating Scale Fusaric Acid Neuroleptic Treatment
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