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

Chika Kubota, Toshiya Inada, Shih Ku Lin, Ajit Avasthi, Kok Yoon Chee, Andi Jayalangkara Tanra, Shu Yu Yang, Lian Yu Chen, Mian Yoon Chong, Adarsh Tripathi, Roy Abraham Kallivayalil, Sandeep Grover, Seon Cheol Park, Takahiro A. Kato, Yu Tao Xiang, Kang Sim, Margarita M. Maramis, Isa Multazam Noor, Chay Hoon Tan, Norman SartoriusNaotaka Shinfuku

Research output: Contribution to journalArticlepeer-review

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).

Original languageEnglish
JournalHuman Psychopharmacology
DOIs
Publication statusAccepted/In press - 2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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