{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T11:00:03Z","timestamp":1774090803225,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Taiwan National Science and Technology Council","award":["112-2314-B-182-070-MY3"],"award-info":[{"award-number":["112-2314-B-182-070-MY3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Hypothesis<\/jats:title>\n                    <jats:p>Drug-induced dystonia and dyskinesia are associated with increased all-cause mortality, with limited data on cause-specific mortality. We aim to confirm mortality risk and cause-specific mortality in drug-induced acute dystonia or tardive dyskinesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>From Taiwan\u2019s National Health Insurance Database (2015\u20132021), we identified adults with \u22652 psychiatrist- or neurologist-confirmed diagnoses of drug-induced acute dystonia or tardive dyskinesia, and created 1:4 age- and sex-matched population controls and an unaffected sibling cohort. Outcomes included all-cause, natural-cause, and unnatural-cause mortality expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable Cox models were adjusted for sex, age, urbanization, socioeconomic status, and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Results<\/jats:title>\n                    <jats:p>A total of 2862 patients and 11\u2009448 matched controls were identified. Mean age was 64.6\u00a0years, 67.2% female, mean follow-up duration was 4.5\u00a0years. Drug-induced acute dystonia or tardive dyskinesia was associated with significant excess risk of all-cause (HR\u2009=\u20091.51, 95% CI 1.36\u20131.67), natural-cause (1.39, 1.25\u20131.55), and unnatural-cause (3.67, 2.42\u20135.54) mortality. For natural-cause mortality, mortality risk was elevated for endocrine, nutritional, and metabolic diseases; mental and behavioral disorders; nervous, circulatory, and respiratory system diseases; but reduced for neoplasms. For unnatural-cause mortality, both accidents and suicides revealed higher mortality risks. Results were similar across age groups and ten psychiatric comorbidities. Sex subgroup analysis revealed higher suicide mortality risk in females than males.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Drug-induced acute dystonia and tardive dyskinesia are associated with elevated all-cause, natural-cause, unnatural-cause, and cause-specific mortalities, highlighting the need for targeted interventions to prevent these specific causes of deaths.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/schbul\/sbaf247","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:00:31Z","timestamp":1765544431000},"source":"Crossref","is-referenced-by-count":0,"title":["All-Cause and Cause-Specific Mortality in Drug-Induced Dystonia and Dyskinesia: Evidence from a Population-Based Cohort"],"prefix":"10.1093","volume":"52","author":[{"given":"Yang-Chieh Brian","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston , Houston, TX 77054 ,","place":["United States"]},{"name":"Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung 833 ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung 833 ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8650-4060","authenticated-orcid":false,"given":"Chih-Wei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung 833 ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1138-5586","authenticated-orcid":false,"given":"Chih-Sung","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical University , Taipei 112,","place":["Taiwan"]},{"name":"Department of Psychiatry, National Defense Medical University , Taipei 114 ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-1073","authenticated-orcid":false,"given":"Mu-Hong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Taipei Veterans General Hospital , Taipei 112 ,","place":["Taiwan"]},{"name":"Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University , Taipei 112 ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5320-1151","authenticated-orcid":false,"given":"Liang-Jen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine , Kaohsiung 833 ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao-Hsu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital , Chiayi 613,","place":["Taiwan"]},{"name":"School of Traditional Chinese Medicine, Chang Gung University , Taoyuan 333,","place":["Taiwan"]},{"name":"Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital , Chiayi 613, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward Chia-Cheng","family":"Lai","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University , Tainan 701,","place":["Taiwan"]},{"name":"Population Health Data Center, National Cheng Kung University , Tainan 701,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,21]]},"reference":[{"key":"2026032106184981200_ref1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.18773\/austprescr.2019.014","article-title":"Drug-induced movement disorders","volume":"42","author":"Duma","year":"2019","journal-title":"Aust Prescr"},{"key":"2026032106184981200_ref2","doi-asserted-by":"publisher","first-page":"959","DOI":"10.3390\/clinpract13040087","article-title":"Overview of movement disorders secondary to drugs","volume":"13","author":"Rissardo","year":"2023","journal-title":"Clin Pract"},{"key":"2026032106184981200_ref3","first-page":"36","article-title":"Antipsychotic-induced movement disorders: evaluation and treatment","volume":"2","author":"Mathews","year":"2005","journal-title":"Psychiatry (Edgmont)"},{"key":"2026032106184981200_ref4","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1177\/0706743718777392","article-title":"Movement disorders associated with antipsychotic medication in people with schizophrenia: an overview of Cochrane reviews and meta-analysis","volume":"63","author":"Martino","year":"2018","journal-title":"Can J Psychiatr"},{"key":"2026032106184981200_ref5","doi-asserted-by":"publisher","first-page":"e264","DOI":"10.4088\/JCP.16r10832","article-title":"Tardive dyskinesia prevalence in the period of second-generation antipsychotic use: a meta-analysis","volume":"78","author":"Carbon","year":"2017","journal-title":"J Clin Psychiatry"},{"key":"2026032106184981200_ref6","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1002\/wps.20994","article-title":"Mortality in people with schizophrenia: a systematic review and meta-analysis of relative risk and aggravating or attenuating factors","volume":"21","author":"Correll","year":"2022","journal-title":"World Psychiatry"},{"key":"2026032106184981200_ref7","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.4088\/JCP.tv17016ah4c","article-title":"Epidemiology, prevention, and assessment of tardive dyskinesia and advances in treatment","volume":"78","author":"Correll","year":"2017","journal-title":"J Clin Psychiatry"},{"key":"2026032106184981200_ref8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.jns.2018.02.012","article-title":"Clinical risk factors for the development of tardive dyskinesia","volume":"389","author":"Solmi","year":"2018","journal-title":"J Neurol Sci"},{"key":"2026032106184981200_ref9","doi-asserted-by":"publisher","first-page":"20451253221117313","DOI":"10.1177\/20451253221117313","article-title":"Pathophysiology, prognosis and treatment of tardive dyskinesia","volume":"12","author":"Takeuchi","year":"2022","journal-title":"Ther Adv Psychopharmacol"},{"key":"2026032106184981200_ref10","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1097\/00004714-200004000-00011","article-title":"Tardive dyskinesia associated with higher mortality in psychiatric patients: results of a meta-analysis of seven independent studies","volume":"20","author":"Ballesteros","year":"2000","journal-title":"J Clin Psychopharmacol"},{"key":"2026032106184981200_ref11","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1192\/bjp.bp.108.049395","article-title":"Mortality and tardive dyskinesia: long-term study using the US National Death Index","volume":"194","author":"Dean","year":"2009","journal-title":"Br J Psychiatry"},{"key":"2026032106184981200_ref12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1097\/JCP.0b013e3181929f94","article-title":"Mortality rates among patients with schizophrenia and tardive dyskinesia","volume":"29","author":"Chong","year":"2009","journal-title":"J Clin Psychopharmacol Feb"},{"key":"2026032106184981200_ref13","doi-asserted-by":"publisher","first-page":"e1001885","DOI":"10.1371\/journal.pmed.1001885","article-title":"The REporting of studies conducted using observational routinely-collected health data (RECORD) statement","volume":"12","author":"Benchimol","year":"2015","journal-title":"PLoS Med Oct"},{"key":"2026032106184981200_ref14","volume-title":"Urban Agglomeration","author":"Tsai","year":"2017"},{"key":"2026032106184981200_ref15","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"2026032106184981200_ref16","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1016\/j.jclinepi.2004.03.012","article-title":"New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality","volume":"57","author":"Sundararajan","year":"2004","journal-title":"J Clin Epidemiol"},{"key":"2026032106184981200_ref17","doi-asserted-by":"publisher","first-page":"e216401","DOI":"10.1001\/jamapediatrics.2021.6401","article-title":"Mortality in persons with autism Spectrum disorder or attention-deficit\/hyperactivity disorder: a systematic review and meta-analysis","volume":"176","author":"Catal\u00e1-L\u00f3pez","year":"2022","journal-title":"JAMA Pediatr"},{"key":"2026032106184981200_ref18","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1192\/bjp.bp.115.171975","article-title":"Increased mortality among people with anxiety disorders: Total population study","volume":"209","author":"Meier","year":"2016","journal-title":"Br J Psychiatry"},{"key":"2026032106184981200_ref19","doi-asserted-by":"publisher","first-page":"e077564","DOI":"10.1136\/bmj-2023-077564","article-title":"All cause and cause specific mortality in obsessive-compulsive disorder: Nationwide matched cohort and sibling cohort study","volume":"384","author":"Fernandez de la Cruz","year":"2024","journal-title":"BMJ"},{"key":"2026032106184981200_ref20","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1186\/s12888-023-04716-w","article-title":"Lifetime posttraumatic stress disorder as a predictor of mortality: a systematic review and meta-analysis","volume":"23","author":"Nilaweera","year":"2023","journal-title":"BMC Psychiatry"},{"key":"2026032106184981200_ref21","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1159\/000535777","article-title":"Mortality and lithium-protective effects after first-episode mania diagnosis in bipolar disorder: a Nationwide retrospective cohort study in Taiwan","volume":"93","author":"Carvalho","year":"2024","journal-title":"Psychother Psychosom"},{"key":"2026032106184981200_ref22","doi-asserted-by":"publisher","first-page":"102547","DOI":"10.1016\/j.cpr.2025.102547","article-title":"A meta-analysis of mortality rates in eating disorders: an update of the literature from 2010 to 2024","volume":"116","author":"Krug","year":"2025","journal-title":"Clin Psychol Rev"},{"key":"2026032106184981200_ref23","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1017\/S2045796014000687","article-title":"Excess mortality from mental, neurological and substance use disorders in the global burden of disease study 2010","volume":"24","author":"Charlson","year":"2015","journal-title":"Epidemiol Psychiatr Sci"},{"key":"2026032106184981200_ref24","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1007\/s00127-021-02055-3","article-title":"Total and cause-specific mortality in patients with personality disorders: the association between comorbid severe mental illness and substance use disorders","volume":"56","author":"H\u00f8ye","year":"2021","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"2026032106184981200_ref25","doi-asserted-by":"publisher","first-page":"317","DOI":"10.3368\/jhr.50.2.317","article-title":"A Practitioner\u2019s guide to cluster-robust inference","volume":"50","author":"Colin Cameron","year":"2015","journal-title":"J Hum Resour"},{"key":"2026032106184981200_ref26","doi-asserted-by":"publisher","first-page":"70","DOI":"10.2302\/kjm.38.70","article-title":"Mortality rate of schizophrenic patients with tardive dyskinesia during 10 years: a controlled study","volume":"38","author":"Yagi","year":"1989","journal-title":"Keio J Med"},{"key":"2026032106184981200_ref27","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/S2215-0366(25)00262-7","article-title":"Mortality from respiratory diseases in individuals with severe mental illness: a large-scale systematic review and meta-analysis of pooled and specific diagnoses","volume":"12","author":"Laguna-Munoz","year":"2025","journal-title":"Lancet Psychiatry"},{"key":"2026032106184981200_ref28","doi-asserted-by":"publisher","first-page":"3267","DOI":"10.1038\/s41380-023-02203-y","article-title":"Antipsychotic dose, dopamine D2 receptor occupancy and extrapyramidal side-effects: a systematic review and dose-response meta-analysis","volume":"28","author":"Siafis","year":"2023","journal-title":"Mol Psychiatry"},{"key":"2026032106184981200_ref29","first-page":"617","article-title":"Adverse effects of antipsychotic medications","volume":"81","author":"Muench","year":"2010","journal-title":"Am Fam Physician"},{"key":"2026032106184981200_ref30","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.schres.2022.07.008","article-title":"Cancer rates and mortality in people with severe mental illness: further evidence of lack of parity","volume":"246","author":"Launders","year":"2022","journal-title":"Schizophr Res Aug"},{"key":"2026032106184981200_ref31","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.schres.2018.03.031","article-title":"Accidental deaths among persons with schizophrenia: a nationwide population-based cohort study","volume":"199","author":"Hellemose","year":"2018","journal-title":"Schizophr Res"},{"key":"2026032106184981200_ref32","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1192\/bjp.2022.140","article-title":"Mortality in psychotic depression: 18-year follow-up study","volume":"222","author":"Paljarvi","year":"2023","journal-title":"Br J Psychiatry"},{"key":"2026032106184981200_ref33","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1093\/schbul\/sbr026","article-title":"Divergent trajectories of physical, cognitive, and psychosocial aging in schizophrenia","volume":"37","author":"Jeste","year":"2011","journal-title":"Schizophr Bull"},{"key":"2026032106184981200_ref34","first-page":"162","article-title":"Medication-induced tardive dyskinesia: a review and update","volume":"17","author":"Cornett","year":"2017","journal-title":"Ochsner J Summer"},{"key":"2026032106184981200_ref35","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10122366","article-title":"Mortality in schizophrenia-Spectrum disorders: recent advances in understanding and management","volume":"10","author":"Peritogiannis","year":"2022","journal-title":"Healthcare (Basel)"},{"key":"2026032106184981200_ref36","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.schres.2005.01.015","article-title":"Trends in the pharmacological treatment of patients with schizophrenia over a 12 year observation period","volume":"77","author":"Edlinger","year":"2005","journal-title":"Schizophr Res"},{"key":"2026032106184981200_ref37","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1111\/bcp.13945","article-title":"Trends in utilization and dosing of antipsychotic drugs in Scandinavia: comparison of 2006 and 2016","volume":"85","author":"Hojlund","year":"2019","journal-title":"Br J Clin Pharmacol"},{"key":"2026032106184981200_ref38","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.comppsych.2005.12.007","article-title":"Combination antipsychotic therapy in psychiatric outpatient clinics in Taiwan","volume":"47","author":"Huang","year":"2006","journal-title":"Compr Psychiatry"},{"key":"2026032106184981200_ref39","doi-asserted-by":"publisher","first-page":"115575","DOI":"10.1016\/j.psychres.2023.115575","article-title":"Schizophrenia patients discharged on antipsychotic polypharmacy from a public psychiatric hospital in Taiwan, 2006-2021","volume":"330","author":"Lin","year":"2023","journal-title":"Psychiatry Res"}],"container-title":["Schizophrenia Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article-pdf\/52\/2\/sbaf247\/67454902\/sbaf247.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article-pdf\/52\/2\/sbaf247\/67454902\/sbaf247.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T10:18:52Z","timestamp":1774088332000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article\/doi\/10.1093\/schbul\/sbaf247\/8532686"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":39,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,3,21]]},"published-print":{"date-parts":[[2026,3,7]]}},"URL":"https:\/\/doi.org\/10.1093\/schbul\/sbaf247","relation":{},"ISSN":["0586-7614","1745-1701"],"issn-type":[{"value":"0586-7614","type":"print"},{"value":"1745-1701","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"sbaf247"}}