Clinical Psychopharmacology and Neuroscience Papers in Press available online.

An Experimental Study to Assess the Professional and Social Consequences of Tardive Dyskinesia
Rajeev Ayyagari 1,*, Debbie Goldschmidt 1, Fan Mu1, Stanley N. Caroff 2,3, Benjamin Carroll 4
1Analysis Group, Inc., Boston, MA, USA, 2Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA, 3Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, 4Teva Pharmaceuticals, West Chester, PA, USA
Objective: Antipsychotic medications may cause tardive dyskinesia (TD), an often-irreversible movement disorder characterized by involuntary movements that are typically stereotypic, choreiform, or dystonic and may impair quality of life. This study evaluated others’ perceptions of abnormal TD movements in professional and social situations.
Methods: This was an experimental, randomized, blinded, digital survey in a general population sample. Participants were randomized 1:1 into a test or control group to view a video of a professional actor simulating TD movements or no TD movements prior to completing surveys on employment, dating, and friendship domains. Assessments for mild-to-moderate and moderate-to-severe TD movements were conducted separately. Authenticity of abnormal movements and AIMS scores were evaluated by physician experts.
Results: Surveys were completed by 2400 participants each for mild-to-moderate and moderate-to-severe TD. In all domains, participants responded significantly less favorably to persons with TD movements (both mild-to-moderate and moderate-to-severe) than those without TD movements. Fewer participants in the test versus control group for mild-to-moderate and moderate-to-severe TD, respectively, considered the candidate as a potential employee (29.2% and 22.7% fewer), found him/her attractive (20.5% and 18.7% fewer), and were interested in becoming friends with him/her (12.3% and 16.5% fewer).
Conclusions: Professional actors simulating TD movements were perceived more negatively than those without TD movements in employment, dating, and friendship domains. To our knowledge, this is the first randomized study to quantify professional and social stigma associated with TD movements that may reduce opportunities for gainful employment, marital status, and an effective support system.
Accepted Manuscript [Submitted on 2021-06-11, Accepted on 2021-07-12]