TY - JOUR
T1 - Dyskinesia is most centrally situated in an estimated network of extrapyramidal syndrome in Asian patients with schizophrenia
T2 - findings from research on Asian psychotropic prescription patterns for antipsychotics
AU - Park, Seon Cheol
AU - Kim, Gyung Mee
AU - Kato, Takahiro A.
AU - Chong, Mian Yoon
AU - Lin, Shih Ku
AU - Yang, Shu Yu
AU - Avasthi, Ajit
AU - Grover, Sandeep
AU - Kallivayalil, Roy Abraham
AU - Xiang, Yu Tao
AU - Chee, Kok Yoon
AU - Tanra, Andi Jayalangkara
AU - Tan, Chay Hoon
AU - Sim, Kang
AU - Sartorius, Norman
AU - Shinfuku, Naotaka
AU - Park, Yong Chon
AU - Inada, Toshiya
N1 - Funding Information:
This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) [2019R1A2C1090146].
Publisher Copyright:
© 2020 The Nordic Psychiatric Association.
PY - 2021
Y1 - 2021
N2 - Background: Network analysis provides a new viewpoint that explicates intertwined and interrelated symptoms into dynamic causal architectures of symptom clusters. This is a process called ‘symptomics’ and is concurrently applied to various areas of symptomatology. Aims: Using the data from Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP), we aimed to estimate a network model of extrapyramidal syndrome in patients with schizophrenia. Methods: Using data from REAP-AP, extrapyramidal symptoms of 1046 Asian patients with schizophrenia were evaluated using the nine items of the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). The estimated network of the ordered-categorical DIEPSS items consisted of nodes (symptoms) and edges (interconnections). A community detection algorithm was also used to identify distinctive symptom clusters, and correlation stability coefficients were used to evaluate the centrality stability. Results: An interpretable level of node strength centrality was ensured with a correlation coefficient. An estimated network of extrapyramidal syndrome showed that 26 (72.2%) of all possible 35 edges were estimated to be greater than zero. Dyskinesia was most centrally situated within the estimated network. In addition, earlier antipsychotic-induced extrapyramidal symptoms were divided into three distinctive clusters–extrapyramidal syndrome without parkinsonism, postural instability and gait difficulty-dominant parkinsonism, and tremor-dominant parkinsonism. Conclusions: Our findings showed that dyskinesia is the most central domain in an estimated network structure of extrapyramidal syndrome in Asian patients with schizophrenia. These findings are consistent with the speculation that acute dystonia, akathisia, and parkinsonism could be the risk factors of tardive dyskinesia.
AB - Background: Network analysis provides a new viewpoint that explicates intertwined and interrelated symptoms into dynamic causal architectures of symptom clusters. This is a process called ‘symptomics’ and is concurrently applied to various areas of symptomatology. Aims: Using the data from Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP), we aimed to estimate a network model of extrapyramidal syndrome in patients with schizophrenia. Methods: Using data from REAP-AP, extrapyramidal symptoms of 1046 Asian patients with schizophrenia were evaluated using the nine items of the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). The estimated network of the ordered-categorical DIEPSS items consisted of nodes (symptoms) and edges (interconnections). A community detection algorithm was also used to identify distinctive symptom clusters, and correlation stability coefficients were used to evaluate the centrality stability. Results: An interpretable level of node strength centrality was ensured with a correlation coefficient. An estimated network of extrapyramidal syndrome showed that 26 (72.2%) of all possible 35 edges were estimated to be greater than zero. Dyskinesia was most centrally situated within the estimated network. In addition, earlier antipsychotic-induced extrapyramidal symptoms were divided into three distinctive clusters–extrapyramidal syndrome without parkinsonism, postural instability and gait difficulty-dominant parkinsonism, and tremor-dominant parkinsonism. Conclusions: Our findings showed that dyskinesia is the most central domain in an estimated network structure of extrapyramidal syndrome in Asian patients with schizophrenia. These findings are consistent with the speculation that acute dystonia, akathisia, and parkinsonism could be the risk factors of tardive dyskinesia.
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U2 - 10.1080/08039488.2020.1777462
DO - 10.1080/08039488.2020.1777462
M3 - Article
C2 - 32580668
AN - SCOPUS:85087464185
VL - 75
SP - 9
EP - 17
JO - Nordic Journal of Psychiatry
JF - Nordic Journal of Psychiatry
SN - 0803-9488
IS - 1
ER -