Tardive dyskinesia associated with higher mortality in psychiatric patients: Results of a meta-analysis of seven independent studies

This article reports a meta-analysis of seven independent studies on the as sociation of tardive dyskinesia with all-cause mortality in psychiatric pat ients. Most of the studies included provide either small sample sizes or fo llow-up periods too short to reach a substantive conclusion on their own. I n the meta-analysis, the overall odds ratio (OR) was significant when calcu lated either by the fixed-effects model (OR = 1.4, 95% confidence interval [CI] = 1.2-1.7, p < 0.005) or the random-effects model (OR = 1.4, 95% CI = 1.1-1.8, p < 0.005). There was no overall heterogeneity (Q test = 8.1, elf = ?,p = 0.32). The overall estimate changed within study designs (OR = 1.4, p = 0.002 in three prospective controlled studies; OR = 2.2, p = 0.02 in tw o prospective uncontrolled studies; and OR = 0.9, p = 0.80 in two retrospec tive controlled studies). It was modified upward when the two most influent ial studies (one prospective and one retrospective) were removed from the o verview (OR = 2.2, 95% CI = 1.4-3.5, p = 0.001; Q test = 0.81, df = 4,p = 0 .94). The conclusion of the meta-analysis was that tardive dyskinesia must be considered a weak risk factor in terms of mortality. It remains to be el ucidated whether it is a risk factor on its own or just a surrogate for any unknown organic liability.