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Title: Quantitative and qualitative evaluation of drug-induced Parkinsonism
Author: Dobson, Martin J.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2001
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Antipsychotic medications are ubiquitous in the treatment of psychosis. However, relief from positive symptomatology comes at a price. Extrapyramidal side-effects such as drug-induced parkinsonism (DIP) are common and superficial similarities between features of parkinsonism and those of psychosis hinder efforts to calibrate dosages. The boundary between psychopathology and drug-induced disorder is a major conceptual issue in psychiatry. Instrumental assessment promises the opportunity to more accurately gauge this boundary. Three hypotheses were developed: that instrumentation has a role in the assessment of DIP, that bradykinesia is the predominant feature of DIP, and that cognitive and subjective features of parkinsonism are present in DIP. Instrumentation procedures were selected to objectively asses the three major features of parkinsonisms: bradykinesia, rigidity, and tremor. Subjective ratings of symptomatology associated with psychosis and antipsychotic mediation were taken. All the measures used were evaluated empirically relative to standard observer rating criteria and the constructs underlying the assessments were examined. The instrumental assessment techniques demonstrated moderate to high accuracy though most did not display significant advantages over clinical rating procedures. However, a role was proposed for performance measures in regular monitoring of bradykinesia. Stronger support was found for the latter two hypotheses. Results indicated that a greater degree and prevalence of abnormality relative to the control group was present in bradykinesia than the other features of parkinsonism. Empirical evidence demonstrated the presence of a cognitive deficit in behaviour associated with the presence of parkinsonism. The evidence from the study also bears on issues of drug tolerability. Support was provided for suggestions that the atypical antipsychotic, clozapine, has a uniquely low liability to induce parkinsonism.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available