MIND-TD Questionnaire Developed as New Clinical Tool to Screen for Tardive Dyskinesia

An interdisciplinary team of health care professionals (HCPs) has developed the MIND-TD questionnaire to improve tardive dyskinesia (TD) screening, named after its evaluation questions on the following topics: movement, impact, notice, and daily activities. They presented their development and revision process via poster at Psych Congress Elevate 2022 in Las Vegas, Nevada.

“The MIND-TD questionnaire was developed to help [HCPs] screen for tardive dyskinesia (TD), a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics and other dopamine receptor blocking agents,” the authors explained.

The expert panel, which includes 4 psychiatrists, 6 neurologists and/or movement disorder specialists, and 3 advanced practice providers, suggests that MIND-TD be administered to all patients at risk for TD or who have a TD diagnosis. Part 1 of the questionnaire (MIND) uses yes-or-no terms to inquire about “extra or unwanted movements” (movement), feeling “embarrassed or self-conscious” about said movements (impact), whether anyone else has seen extra movements (notice), and if movements interfere with daily routines (daily activity). This first section can be administered by any trained medical staff either in person or via telehealth options.

Related: The Impact of Tardive Dyskinesia Across Lifestyle Domains

Depending on the responses to Part 1, Part 2 (TD) should be conducted by the treating HCP and can also be done either in person or via telehealth. In Part 2, the “Thorough Interview” asks patients about 9 different subjects relating to physical/functional difficulties, including difficulty swallowing, challenges speaking, balance, and fidgeting. It also involves 3 simple speech exercises to check for articulation problems.

The “Differentiate” section of Part 2 calls for visual observation of the patient to determine whether the presenting symptoms are caused by TD or another drug-induced movement disorder (DIMD). Not only does the questionnaire instruct on what to look for (eg, “increased blinking,” “rocking/jerking” in the extremities), but it also provides caution against potential errors (eg, “confirm patient is not chewing any gum or candy”).

“MIND-TD…can facilitate dialogue between HCPs and patients about the risks, symptoms, and impact of TD,” the authors concluded, and “can be used to help differentiate TD from other DIMDs so that appropriate treatment decisions can be made.”

Reference

Lundt L, Jain R, Matthews D, et al. Development of the MIND-TD questionnaire as a screening tool for tardive dyskinesia. Poster presented at: Psych Congress Elevate, June 3-5, 2022, Las Vegas, Nevada.