The videos in this quiz depict involuntary movements in real patients. As the videos play, decide whether the movements should count toward the patient’s Abnormal Involuntary Movement Scale (AIMS) score. Are the movements consistent with tardive dyskinesia (TD), another movement disorder, or is there mixed presentation?
After answering each question, view expert commentary on the movements depicted in the videos.
The AIMS is a 12-item, clinician-rated scale used to assess symptom severity in patients with TD.1 The first 7 items score the severity of TD in various body regions on a scale from 0 (none) to 4 (severe). The body regions assessed by the AIMS include: facial and oral movements, extremity movements, and trunk movements.1 Importantly, TD is one of several drug-induced movement disorders and can present together with other movement disorders in the same patient.2 So, it is important to differentiate movements of TD from those of other disorders when rating movement severity on the AIMS. Ratings of tremor, which are not consistent with TD, are specifically excluded from the AIMS score.3 Similarly, steady muscular resistance (cogwheeling) associated with parkinsonism, standing fore flexed posture of parkinsonism, or voluntary movements resulting from subjective restlessness and urge to move associated with akathisia should not contribute to the AIMS score.3
Experts agree that no specific score threshold suggests the need for intervention; instead, clinicians should consider the impact of the TD movements on the individual patient.4 Even one rating of mild severity (ie, ≥2 on the AIMS) could represent TD that may benefit from treatment.5 Click here for more information.
2. Hauser RA, Meyer JM, Factor SA, et al. Differentiating tardive dyskinesia: a video-based review of antipsychotic-induced movement disorders in clinical practice. CNS Spectr. 2020;27(2):208-217.
3. Menzies V, Farrell S. Schizophrenia, tardive dyskinesia, and the abnormal involuntary movement scale (AIMS). J Am Psych Nurses Assoc. 2002;8(2):51-56.
4. American Psychiatric Association. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. American Psychiatric Association; 2021.
5. Caroff SN, Citrome L, Meyer J, et al. A modified Delphi consensus study of the screening, diagnosis, and treatment of tardive dyskinesia. J Clin Psychiatry. 2020;81(2):19cs12983.