How Does Tardive Dyskinesia Impact Occupational Function?

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Patients and physicians agreed that tardive dyskinesia caused significant work impairment, with some patients completely unable to obtain or maintain a job.

Tardive dyskinesia (TD) substantially contributes to work absenteeism and the inability to obtain or maintain employment, according to an abstract published in Parkinsonism & Related Disorders.

“TD is a movement disorder that markedly impacts patients,” wrote Rinat Ribalov, the lead author of the study. “TD-related abnormal, involuntary movements can impair fine motor skills, making employment challenging.”

Surveying Patients & Physicians

The study explored patient and physician attitudes toward TD, particularly through the lens of occupational impairment.

The researchers included 435 adult patients and 340 neurologists and psychiatrists who treated at least three patients with TD in the last two years. All participants completed anonymous online surveys that used an adapted version of the Work Productivity and Activity Impairment Questionnaire. The study population spanned several countries, including Australia, Brazil, China, Israel, and South Korea.

Patients had been diagnosed with TD in addition to an underlying psychiatric condition such as schizophrenia, schizoaffective disorder, bipolar disorder, or major depressive disorder. Patients also reported experiencing extra, irregular movements.

TD’s Impact on Work Impairment

Less than half of patients were employed at the time of the questionnaire (43%; n=187). In the last week, patients reported working on average of 35.8 (SD, 15.7) hours and missing an average 6.3 (SD, 9.3) hours because of TD.

“The most common specific reason given was that patients felt physically incapable of working due to TD symptoms,” Dr. Ribalov and colleagues reported.

Findings showed that 44% of patients reported being physically incapable of work due to their symptoms. Another 23% said they could not find an employer that would hire them because of their symptoms, 19% were embarrassed by their TD, and 15% said they would have to step down or change industries and were not prepared to do so.

The questionnaire also prompted patients to rate the impact on work productivity from 0 to 10, with 0 representing no effect and 10 being complete inability to work. Patients averaged a score of 5.4 (SD, 2.4), with 45.1% reporting that TD significantly affected their work productivity.

Per the findings, 60% of patients reported overall work impairment, 59% reported that TD impaired their work activities, 54% reported experiencing presenteeism, and 15% reported absenteeism.

Most physicians (61%) reported “always or almost always” or “often” assessing TD’s impact on occupational function. About one-third (31%) “sometimes” assessed the impact, and some 8% reported “never/rarely” doing so.

Overall, 72% of physicians perceived that TD had a moderate or very strong impact on patients’ abilities to perform their job duties. In addition, 75% felt TD moderately or very strongly challenged patients’ efforts to get or maintain a job.

The researchers concluded that TD contributed to significant absenteeism and work impairment.

“In these surveys, patients and physicians agreed that TD considerably worsens occupational opportunities and functionality,” Dr. Ribalov and colleagues wrote.