The Curacao Extrapyramidal Syndromes Study comprises a 24-year follow-up study in which patients with severe mental illness (SMI) treated at the only psychiatric hospital on the island of Curaçao were repeatedly assessed for the presence and severity of movement disorders (MD) since 1992. The follow-up study started in 1992 with a cohort of all inpatients of the Dr. D.R. Capriles Hospital located on Curaçao, an island in the Caribbean with a predominantly African-Caribbean population. All patients were free from organic disorders that could cause movement disorders and had a history of antipsychotic use for at least three months. Included in the study were 194 patients with a mean age of 53.1 years, with a male-female ratio of 2.7 and the following diagnostic distribution (a patient can have multiple diagnoses): schizophrenia, 77.3%; affective disorder, 5.2%; dementia, 8.2%; mental retardation, 4.6%; cocaine abuse, 13.9%; and other diagnoses, 24.7%. Patients were assessed in 1992, 1993, 1994, 1996, 1997, 1998, 2001, and 2009 for tardive dyskinesia (TD), Parkinsonism, akathisia, and medication use.