The factor structure of extrapyramidal symptoms evaluated using the Drug-Induced Extrapyramidal Symptoms Scale in patients with schizophrenia: Results from the 2016 REAP AP-4 study

Kubota C 1 , Inada T 2 , Lin SK 3 , Avasthi A 4 , Chee KY 5 , Tanra AJ 6 Show all authors , Yang SY 7 , Chen LY 8 , Chong MY 9 , Tripathi A 10 , Kallivayalil RA 11 , Grover S 4 , Park SC 12 , Kato TA 13 , Xiang YT 14 , Sim K 15 , Maramis MM 16 , Noor IM 17 , Tan CH 18 , Sartorius N 19 , Shinfuku N 20

Affiliations 

  • 1 Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
  • 2 Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Nagoya, Japan
  • 3 Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
  • 4 Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  • 5 Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  • 6 Faculty of Medicine, Department of Psychiatry, Hasanuddin University, Makassar, Indonesia
  • 7 Taipei City Hospital and Psychiatric Center, Taipei, Taiwan
  • 8 Kunming Prevention and Control Center, Taipei City Hospital, Taipei, Taiwan
  • 9 Health Management International, Singapore, Singapore
  • 10 Department of Psychiatry, King George's Medical University, Chowk, India
  • 11 Department of Psychiatry, Pushpagiri Institute of Medical Sciences and Research Centre, Kerala, Thiruvalla, India
  • 12 Department of Psychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea
  • 13 Department of Neuropsychiatry, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
  • 14 Unit of Psychiatry, Department of Public Health and Medicinal Administration, University of Macau, Macao SAR, China
  • 15 West Region. Institute of Mental Health, Singapore, Singapore
  • 16 Department of Psychiatry, Airlangga University, Surabaya, Indonesia
  • 17 Dr Soeharto Heerdjan Mental Hospital, Jakarta, Indonesia
  • 18 Department of Pharmacology, National University of Singapore, Singapore, Singapore
  • 19 Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
  • 20 International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
Hum Psychopharmacol, 2023 Mar;38(2):e2861.
PMID: 36462184 DOI: 10.1002/hup.2861

Abstract

INTRODUCTION: Drug-induced extrapyramidal syndrome (EPS) remains a major problem in clinical psychiatry. This study aimed to examine the factor structure of drug-induced extrapyramidal symptoms observed in patients with schizophrenia and assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS).

METHODS: The participants were 1478 patients with a diagnosis of schizophrenia whose EPS was assessed using the DIEPSS in India, Indonesia, Japan, Malaysia, and Taiwan in the 2016 REAP AP-4 study. The records of the participants were randomly divided into two subgroups: the first for exploratory factor analysis of the eight DIEPSS items, and the second for confirmatory factor analysis.

RESULTS: The factor analysis identified three factors: F1 (gait and bradykinesia), F2 (muscle rigidity and tremor), and F3 (sialorrhea, akathisia, dystonia, and dyskinesia).

CONCLUSION: The results suggest that the eight individual items of the DIEPSS could be composed of three different mechanisms: acute parkinsonism observed during action (F1), acute parkinsonism observed at rest (F2), and central dopaminergic mechanisms with pathophysiology other than acute parkinsonism (F3).

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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