  AIMS (Abnormal Involuntary Movement Scale)
Persons taking any kind of antipsychotic medication need to be monitored for movement disorders. The AIMS (Abnormal Involuntary Movement Scale) aids in the early detection of tardive dyskinesia as well as providing a method for on-going surveillance.
Although the incidence of TD has been relatively low in recent years, changes in prescribing may result in increased occurrence. Clinicians will need to be alert to these possibilities and employ tools that will help them pick up developing problems as soon as possible.
This simple checklist takes only 10 minutes to complete and uses a 5-point rating scale for recording scores for 7 body areas: face, lips, jaw, tongue, upper extremities, lower extremities, and trunk.
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- Instructional Video For AIMS Scale
An instructional video has been created to show how to conduct the AIMS examination and how to score the findings. Dr. Jay Pomerantz demonstrates each step of the AIMS procedure. With the help of a "standardized patient", he also shows what the different levels of symptom severity look like and explains how they should be scored.
It is suggested that you download and print out the AIMS Form and the AIMS Instructions before viewing the Instructional Video so that you will be able to follow along on each step of the examination and the scoring of the abnormal movements.
Downloading and printing out the AIMS Instructional Video Program Guide also in advance of viewing the video will give you a complete description of the information on the video and the length of time of each segment so you can skip forward and back.
- Movement Disorders and Tardive Dyskinesia (PDF)
By Jay M. Pomerantz, MD Psychiatric Times 23 (7), June 2006
A multidisciplinary panel of experts representing psychiatry, primary care, pharmacy, managed care and emergency psychiatry met to update recent developments in the management of schizophrenia. This article is the presentation that focused on movement disorders and TD from that symposium. Published in June 2006, it includes commentary from participants from different practice settings.
The original publication of the AIMS is often cited as: Guy W. ECDEU Assessment Manual for Psychopharmacology, Rockville, MD, US Department of Health, Education, and Welfare, 1976. However, that publication and a number of the other pioneering studies are either unavailable or not readily available on-line.
The following two articles illustrate the continued value of the AIMS in different types of investigations.
- Lower Risk for Tardive Dyskinesia Associated With Second-Generation Antipsychotics: A Systematic Review of 1-Year Studies
By Cristoph U. Correll, MD, et. al., The American Journal of Psychiatry, 161:414, March 2004
This report from March 2004 illustrates the use of the AIMS in studies to assess the risk of TD associated with the use of second-generation antipsychotics.
- Nithsdale Schizophrenia Surveys 23: movement disorders 20-year review
By Jennifer Halliday, MRCPsych, et al., The British Journal of Psychiatry 181:422, 2002
The AIMS is also useful for long-term followup. This 2002 study reviews the prevalence of movement disorders in a discrete area of Scotland that had been studied serially for two decades.
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Jay M. Pomerantz, MD
Assistant Clinical Professor of Psychiatry
Harvard Medical School, Boston
A large number of psychiatric tests, scales, and forms have been created over the years to help in diagnosing mental illness and assisting in treatment and follow-up. This Web-based service offers copies of some of the most popular and useful instruments. The hope is that healthcare professionals—whether in specialty practices, primary-care settings, or emergency services—will find this format convenient and useful, allowing them to find the right instrument quickly, print it out for immediate use with patients, and add the findings to their records. Since most of the tools are designed for repeated use over time, they will provide not only a longitudinal view but also document the medical record.
In addition to the forms themselves, you will find instructions on how to administer and score the scales as well as related articles and links to other useful guidance. When appropriate, we will supply video resources for additional insights.
These scales have demonstrated high levels of accuracy and validity and the results can give important clues to possible mental disorders that warrant follow up. However, please remember that they depend on the skills of the clinicians administering them and the accuracy of the information provided by the patients.
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