Relationship between drug-induced movement disorders and psychosis in adults living in precarious housing or homelessness

David D Kim; Ric M Procyshyn; Andrea A Jones; Kristina M Gicas; Paul W Jones; Anna M Petersson; Lik Hang N Lee; Rachel McLellan-Carich; Lianne L Cho; William J Panenka; Olga Leonova; Donna J Lang; Allen E Thornton; William G Honer; Alasdair M Barr

doi:10.1016/j.jpsychires.2024.01.003

Relationship between drug-induced movement disorders and psychosis in adults living in precarious housing or homelessness

J Psychiatr Res. 2024 Feb:170:290-296. doi: 10.1016/j.jpsychires.2024.01.003. Epub 2024 Jan 3.

Authors

Affiliations

¹ Department of Anesthesiology, Pharmacology & Therapeutics, 2176 Health Sciences Mall, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada; British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada.
² British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
³ British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada.
⁴ Department of Psychology, University of the Fraser Valley, Abbotsford, BC, Canada.
⁵ Department of Psychology, Simon Fraser University, Burnaby, BC, Canada.
⁶ Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
⁷ British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
⁸ Department of Anesthesiology, Pharmacology & Therapeutics, 2176 Health Sciences Mall, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada; British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada. Electronic address: al.barr@ubc.ca.

PMID: 38185074
DOI: 10.1016/j.jpsychires.2024.01.003

Abstract

Background: Studies have reported positive associations between drug-induced movement disorders (DIMDs) and symptoms of psychosis in patients with schizophrenia. However, it is not clear which subtypes of symptoms are related to each other, and whether one symptom precedes another. The current report assessed both concurrent and temporal associations between DIMDs and symptoms of psychosis in a community-based sample of homeless individuals.

Methods: Participants were recruited in Vancouver, Canada. Severity of DIMDs and psychosis was rated annually, allowing for the analysis of concurrent associations between DIMDs and Positive and Negative Syndrome Scale (PANSS) five factors. A brief version of the PANSS was rated monthly using five psychotic symptoms, allowing for the analysis of their temporal associations with DIMDs. Mixed-effects linear and logistic regression models were used to assess the associations.

Results: 401 participants were included, mean age of 40.7 years (SD = 11.2) and 77.4% male. DIMDs and symptoms of psychosis were differentially associated with each other, in which the presence of parkinsonism was associated with greater negative symptoms, dyskinesia with disorganized symptoms, and akathisia with excited symptoms. The presence of DIMDs of any type was not associated with depressive symptoms. Regarding temporal associations, preceding delusions and unusual thought content were associated with parkinsonism, whereas dyskinesia was associated with subsequent conceptual disorganization.

Conclusions: The current study found significant associations between DIMDs and symptoms of psychosis in individuals living in precarious housing or homelessness. Moreover, there were temporal associations between parkinsonism and psychotic symptoms (delusions or unusual thought content), and the presence of dyskinesia was temporally associated with higher odds of clinically relevant conceptual disorganization.

Keywords: Antipsychotic; Drug-induced movement disorder; Dyskinesia; Homelessness; Parkinsonism; Psychosis.

MeSH terms

Adult
Dyskinesias*
Female
Housing
Humans
Ill-Housed Persons*
Male
Parkinsonian Disorders*
Psychotic Disorders* / epidemiology