The Dyskinesia Identification System: Condensed User Scale (DISCUS) was developed as a standardized rating scale to evaluate patients for signs of tardive dyskinesia. The DISCUS total score may be followed over time to assess a patient's response to different therapeutic interventions.
Patient Evaluation:
(1) A standardized evaluation form was developed for recording clinical findings (see Figure 1, page 53, Sprague 1991).
(2) 15 movements seen in tardive dyskinesia divided into 7 body areas as follows:
|
Body Area |
Movements |
|
facial |
tics |
|
|
grimaces |
|
ocular |
blinking |
|
oral |
chewing or lip smacking |
|
|
puckering, sucking, or thrusting lower lip |
|
lingual |
tongue thrusting, or tongue in cheek |
|
|
tonic tongue |
|
|
tongue tremor |
|
|
athetoid, myokymic, lateral tongue |
|
head, neck, trunk |
retrocollis or torticollis |
|
|
shoulder or hip torsion |
|
upper limb |
athetoid, myokymic finger-wrist-arm |
|
|
pill rolling |
|
lower limb |
ankle flexion or foot tapping |
|
|
toe movement |
Movement Assessment:
• Each movement is scored according to the following schema:
|
Level |
Description |
Score |
|
not present |
movements not observed or some movements observed but not considered abnormal |
0 |
|
minimal |
abnormal movements are difficult to detect or movements are easy to detect but occur only once or twice in a short non-repetitive manner |
1 |
|
mild |
abnormal movements occur infrequently and are easy to detect |
2 |
|
moderate |
abnormal movements occur frequently and are easy to detect |
3 |
|
severe |
abnormal movements occur almost continuously and are easy to detect |
4 |
|
not assessed |
an assessment for an item is not able to be made |
NA |
total score =
= SUM(points for all 15 items)
Interpretation:
• The DISCUS total score >= 5 is a valid measure of tardive dyskinesia.
Purpose: To assess a person with tardive dyskinesia using the Dyskinesia Identification System: Condensed User Scale (DISCUS).
Specialty: Psychiatry
Objective: criteria for diagnosis
ICD-10: G24.0,
