Anosognosia in Tardive Dyskinesia: "Tardive Dysmentia" or "Tardive Dementia"?

Wilson et al. (1983) called attention to the increasing incidence of affective symptomatology in schizophrenic patients on chronic neuroleptic medication. They designated the emerging syndrome as tardive dysmentia in order to emphasize its connection with the pathophysiology of tardive dyskinesia. The present contribution suggests that the emotional indifference or frank anosognosia of abnormal involuntary movements noted in the great majority (95 percent) of patients with tardive dyskinesia is another possible feature of tardive dysmentia. An attempt was made to explain anosognosia, and some difficulties that mar interpretation of data were pointed out. Anosognosia was proposed to represent a symptom related to some sort of cognitive disorder accompanying tardive dyskinesia, at least in the elderly. It was suggested that dementia may be associated with a predominant impairment of dopaminergic circuitry in the right cerebral hemisphere.