Citation

Cuesta MJ, García de Jalón E, Campos MS, Moreno-Izco L, Lorente-Omeñaca R, Sánchez-Torres AM, Peralta V. Schizophr. Res. 2018; 200: 97-103.

Affiliation

Mental Health Department of Servicio Navarro de Salud, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.schres.2017.08.050

PMID

28890132

Abstract

Motor abnormalities (MAs) are highly prevalent in patients with first-episode psychosis both before any exposure and after treatment with antipsychotic drugs. However, the extent to which these abnormalities have predictive value for long-term psychosocial functioning is unknown. One hundred antipsychotic-naive first-episode psychosis (FEP) patients underwent extensive motor evaluation including catatonic, parkinsonism, dyskinesia, akathisia and neurological soft signs. Patients were assessed at naïve state and 6 months later. Patients were followed-up in their naturalistic treatment and settings and their psychosocial functioning was assessed at 6-month, 1year, 5year and 10years from the FEP by collecting all available information. A set of linear mixed models were built to account for the repeated longitudinal assessment of psychosocial functioning during the follow-up regarding to the five domains of MAs (catatonic, parkinsonism, akathisia, dyskinesia and neurologic soft-signs) at index episode at antipsychotic naïve state and after 6 months of FEP. Basic epidemiological variables, schizophrenia diagnosis and average of chlorpromazine equivalent doses of antipsychotic drugs were included as covariates. Catatonic signs and dyskinesia at drug-naïve state were significantly associated with poor long-term psychosocial functioning. Moreover, higher scores on parkinsonism, akathisia, neurological soft signs and catatonic signs at 6-month of FEP but not dyskinesia showed significant associations with poor long-term psychosocial functioning. Our results added empirical evidence to motor abnormalities as core manifestations of psychotic illness before and after antipsychotic treatment with high predictive value for poor long-term psychosocial functioning in FEP patients.

Copyright © 2017 Elsevier B.V. All rights reserved.

Language: en

Keywords

Abnormal movements; Catatonia; Extrapyramidal signs; Neurological assessment; Neurological soft signs; Psychosocial functioning; Schizophrenia