David Baxter PhD
Late Founder
Spontaneous abnormal movement 'a part of schizophrenia'
By Liam Davenport
24 November 2008
Psychol Med 2008; Advance online publication
Spontaneous abnormal movements are part of a wider neurodysfunction that is intrinsic to the pathogenesis of schizophrenia, say UK researchers who call for studies of the underlying neuronal pathways.
Previous investigations have revealed spontaneous movement disorders (SMDs), including spontaneous dyskinesia and parkinsonism, in antipsychotic medication-na?ve schizophrenia patients. However, such disorders have only been recorded in patients with chronic schizophrenia.
To determine their presence in antipsychotic-na?ve patients with first-episode psychosis, S Pappa and P Dazzan from King's College London performed a literature search of the Medline, PsychLit, and EMBASE databases for studies that reported on the prevalence and demographic and clinical correlates of spontaneous dyskinesia or parkinsonism.
In all, 13 first-episode studies of SMDs were identified. The studies involved a total of 741 patients diagnosed with schizophrenia, schizophreniform disorder, schizoaffective disorder, or other psychosis. The average age of patients in the studies ranged from 22.3 years to 42.2 years.
The team reports in the journal Psychological Medicine that the overall median rate of spontaneous dyskinesia was 9%, within a range of 0% to 14%, while the median rate of spontaneous parkinsonism was 17%, within a range of 2.3% to 27.0%.
In contrast, there was insufficient evidence to determine the occurrence of akathisia and dystonia in antipsychotic-na?ve, first-episode psychosis patients.
Examining the clinical correlates of SMDs, the team found that they appeared to be associated with cognitive dysfunction and negative symptoms in a triad described as the "deficit syndrome".
"The findings reviewed support the notion that the SMDs observed in first-episode patients are part of a neurodysfunction related to the pathogenesis underlying the illness, rather than the consequences of neurodegenerative processes," the team concludes.
"Future studies should attempt to provide a greater insight into the role of basal ganglia structures and extrapyramidal pathways in the pathophysiology of schizophrenia."
Abstract
By Liam Davenport
24 November 2008
Psychol Med 2008; Advance online publication
Spontaneous abnormal movements are part of a wider neurodysfunction that is intrinsic to the pathogenesis of schizophrenia, say UK researchers who call for studies of the underlying neuronal pathways.
Previous investigations have revealed spontaneous movement disorders (SMDs), including spontaneous dyskinesia and parkinsonism, in antipsychotic medication-na?ve schizophrenia patients. However, such disorders have only been recorded in patients with chronic schizophrenia.
To determine their presence in antipsychotic-na?ve patients with first-episode psychosis, S Pappa and P Dazzan from King's College London performed a literature search of the Medline, PsychLit, and EMBASE databases for studies that reported on the prevalence and demographic and clinical correlates of spontaneous dyskinesia or parkinsonism.
In all, 13 first-episode studies of SMDs were identified. The studies involved a total of 741 patients diagnosed with schizophrenia, schizophreniform disorder, schizoaffective disorder, or other psychosis. The average age of patients in the studies ranged from 22.3 years to 42.2 years.
The team reports in the journal Psychological Medicine that the overall median rate of spontaneous dyskinesia was 9%, within a range of 0% to 14%, while the median rate of spontaneous parkinsonism was 17%, within a range of 2.3% to 27.0%.
In contrast, there was insufficient evidence to determine the occurrence of akathisia and dystonia in antipsychotic-na?ve, first-episode psychosis patients.
Examining the clinical correlates of SMDs, the team found that they appeared to be associated with cognitive dysfunction and negative symptoms in a triad described as the "deficit syndrome".
"The findings reviewed support the notion that the SMDs observed in first-episode patients are part of a neurodysfunction related to the pathogenesis underlying the illness, rather than the consequences of neurodegenerative processes," the team concludes.
"Future studies should attempt to provide a greater insight into the role of basal ganglia structures and extrapyramidal pathways in the pathophysiology of schizophrenia."
Abstract
