Tardive dyskinesia (TD), a persistent involuntary movement disorder linked to long-term antipsychotic use, is often underreported or misdiagnosed in routine clinical practice. This retrospective study analyzed electronic health records (EHRs) from over 32,000 US adults with psychotic disorders who were prescribed antipsychotics between 1999 and 2021. Researchers identified patients with either abnormal movements suggestive of TD or documented TD through manual review of clinical notes. While 1,301 patients had clinical indicators of TD in unstructured EHR data, only 64 (4.9%) of them had a formal ICD-coded diagnosis—indicating a significant gap in diagnosis and documentation.

Findings suggest racial and clinical setting disparities in TD diagnosis. Black/African American patients were significantly less likely to receive an ICD-TD diagnosis compared to white patients. Patients treated at community mental health centers were more likely to receive a diagnosis than those treated at academic medical centers. These results underscore the need for improved recognition and documentation of TD in clinical settings to ensure timely intervention and equitable access to treatment. Better diagnostic practices could help identify patients who may benefit from newer therapeutic options for managing TD.

Reference: Griffiths K, Won Y, Lee Z, Wang L, Correll CU, Patel R. Identifying the diagnostic gap of tardive dyskinesia: an analysis of semi-structured electronic health record data. BMC Psychiatry. 2025;25(1):407. doi: 10.1186/s12888-025-06780-w.