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Background: The aim of this study was to examine whether there was an association between tardive dyskinesia (TD) and number of functional CYP2D6 genes., Methods: A Caucasian sample of 70 patients was recruited in 1996-1997 from South London and Maudsley National Health Service (NHS) Foundation Trust, UK. Subjects had a DSM-IIIR diagnosis of schizophrenia and were treated with typical antipsychotics at doses equivalent to at least 100 mg chlorpromazine daily for at least 12 months prior to assessment. All patients were genotyped for CYP2D6 alleles*3-5, *41, and for amplifications of the gene., Results: There were 13 patients with TD. The mean (standard deviation (SD)) years of duration of antipsychotic treatment in TD-positive was 15.8 (7.9) vs TD-negative 11.1 (7.4) (p=0.04). Increased odds of experiencing TD were associated with increased ability to metabolize CYP2D6, as measured by genotypic category (odds ratio (OR)=4.2), increasing duration in treatment (OR=1.0), and having drug-induced Parkinsonism (OR=9.7)., Discussion: We found a significant association between CYP2D6 genotypic category and TD with the direction of effect being an increase in the number of functional CYP2D6 genes being associated with an increased risk of TD. This is the first study to examine the association between TD and CYP2D6 in Caucasians with this number of genotypic categories. In the future, metabolomics may be utilized in the discovery of biomarkers and novel drug targets., (© The Author(s) 2014.)

Background: Early intervention services (EIS) for psychosis are becoming widespread. Structured methods of assessment are advocated in these services, but a consensus is still needed on a package of measures with good psychometric properties that is feasible and reliable for routine use in this setting., Methods: A computerised assessment package (MiData) was designed to provide clinicians with easy-to-understand feedback about clients' progress and to allow evaluation of the whole service for both audit and research purposes. Core areas include symptoms, duration of untreated psychosis (DUP), pathways into care, social functioning, and substance misuse at initial intake and annually thereafter., Results: MiData has been adopted by EIS throughout London and in some other centres. Baseline data are now available regarding 533 first-episode psychosis patients who presented to 8 London teams. The completeness of the data varied across teams and measures, with fullest completion for sociodemographic data (99% on some measures) and poorest for DUP. The average London EIS client is male, single, unemployed and comes from Black or Minority Ethnic group. Most (70%) demonstrated poor social functioning at intake, over a third (38%) reported substance abuse problems and 23% had harmed themselves or others in the previous 6 months., Conclusions: MiData provides a clinician-friendly system of evaluating first-episode psychosis services but requires further refinement and dedicated resources to improve completion rates. This method of collecting routine data is of use to clinicians, managers, health service researchers and commissioners and potentially it may enable naturalistic comparisons between different models of care.