Patient and physician perceptions of the burden of tardive dyskinesia: an international survey.

Background: Tardive dyskinesia (TD) negatively affects overall quality of life (QoL) and day-to-day activities, and perceptions of these effects and their impact may vary between cultures and societies, or providers and patients. Physicians' discernments of this burden could improve efforts to detect, diagnose and treat TD. This study assessed TD impact from both patients' and physicians' perspectives in multiple countries. Methods: Patients who self-reported a physician diagnosis of TD and schizophrenia, schizoaffective disorder, bipolar disorder or major depressive disorder exhibiting 'extra, irregular movements' and physicians (neurologists or psychiatrists) who treated ≥3 patients with TD in the prior 2 years participated in individual 20-minute online surveys. Participating physicians and patients were not linked. Results: Patients (N=435) and physicians (N=340) were recruited from Australia, Brazil, China, South Korea and Israel. Most patients (84.8%) and physicians (87.6%) reported a moderate/high or moderate to very strong impact of TD symptoms on QoL. Patients and physicians noted substantial negative impacts of TD on patients' daily lives, emotional and psychological states, and social activities. Many patients reported that TD often/always affected their treatment compliance for their underlying psychiatric condition (28.7%); that TD worsened their underlying psychiatric condition (24.8%), or that they developed other psychiatric conditions (46.9%); most physicians similarly perceived a moderate/very strong impact of TD in these areas (75.3%, 70.9% and 77.6%, respectively). Conclusions: Patients and physicians across participating countries agreed that TD substantially impacts patient QoL and can undermine psychiatric stability by worsening underlying psychiatric conditions and treatment adherence. Also, physicians saw the physical and emotional/psychological/social effects of TD as being almost equally impactful, whereas patients generally reported a greater impact of emotional/psychological/social effects than physical effects. The differences between the levels of importance that patients and physicians assigned to these areas of TD impact highlight the need for more thorough communication between them.