Occupational Impact of Tardive Dyskinesia: A Cross-Sectional, International Survey Assessing the Perceptions and Experiences of Patients With TD and Physicians Who Treat TD

OBJECTIVES: To assess patient and physician perceptions of the impact of tardive dyskinesia (TD) on occupational functionality.

METHODS: Adults (aged ≥18 years) with self-reported physician diagnoses of TD and schizophrenia or schizoaffective disorder, bipolar disorder, or major depressive disorder and TD-related movements were invited to complete an online questionnaire (27 June– 17 October 2022). Certified physicians (neurologists and psychiatrists) practicing for ≥3 years, with ≥60% of their time in direct patient care and treating ≥3 patients with TD in the prior 2 years, were also invited to complete an online questionnaire (27 June– 27 July 2022). Physicians’ and patients’ data and questionnaires were unlinked.

RESULTS: Patients (n=435; mean age, 42.4 years, 52% female) from Australia, China, South Korea, and Brazil and physicians (n=340; 61% psychiatrists) from Australia, China, South Korea, Brazil, and Israel were included in the study. Across countries, 248 (57%) patients reported not currently working. Among the 248 patients not working, 124 (50%) stated that TD symptoms are behind the fact that they are not working. Among these 124 patients, 44% cited physical limitations because of TD symptoms as the primary reason, followed by not being able to find an employer that will employ them because of TD symptoms (23%), embarrassment about TD symptoms (19%), and having to take a step down or change industry (15%). 61% of physicians reported “often”/“always or almost always” assessing impact of TD on occupational functioning. 75% and 72% of physicians perceived a “moderate”/“very strong” impact of TD on obtaining/maintaining employment and on the inability or reduced ability of patients to perform job duties, respectively.

CONCLUSIONS: In these surveys, patients and physicians agreed that TD considerably impacts occupational functionality. Among patients who were unable to work because of their TD, the most common reason for not working was because of TD-related physical limitations.