Tardive Dyskinesia: Barriers to the Professional Recognition of an Iatrogenic Disease

Tardive dyskinesia (TD), once regarded by psychiatrists as a rare occurrence, is currently recognized as the most pervasive side effect (other than sedation) ofantipsychotic medication. Early reports linking antipsychotic drugs to TD met with considerable criticism. Mounting evidence concerning high prevalence of the disorder among psychiatric patients has led to a general acceptance of the syndrome as drug induced, but this recognition has coexisted with elements ofresistance. This paper assesses the social epidemiology ofTD, the process by which TD was generally recognized as a major iatrogenic illness, and coexisting resistance to such recognition. The resistance and incomplete recognition are then discussed in light ofstructural elements of professional dominance. The history of the TD phenomenon informs us that the discovery of illness is a broad sociomedical question rather than merely a biomedical one.