October 1986

Toward a More Reliable Diagnosis of Akathisia

Author Affiliations

Brentwood Veterans Administration Medical Center Wilshire and Sawtelle boulevards Los Angeles, CA 90073

Arch Gen Psychiatry. 1986;43(10):1015-1016. doi:10.1001/archpsyc.1986.01800100109019

To the Editor.—  The article "Akathisia Variants and Tardive Dyskinesia" calls attention to the need for a better operational definition of akathisia. We have maintained for years that akathisia is underrecognized and that it causes considerable suffering.2-6 Our group, as is the custom in the United States, has diagnosed akathisia primarily by the patient's responses to structured questions about inner restlessness and by response to antiparkinsonian drugs.Barnes and Braude, however, are quite right in stating that akathisia cannot be all that reliably diagnosed by the patient's subjective report. We certainly agree that "general com

plaints of emotional unease" or "inner restlessness" are too nonspecific for a diagnosis of akathisia. Barnes and Braude,1 accordingly, have added the more observable criterion for restless leg movements. They state, "A careful distinction was made between patterns of normal, restless movement and abnormal (dyskinetic) movements. This distinction is crucial to the interpretation 

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