Dyskinesia and Parkinsonism in Antipsychotic-naive Patients with Schizophrenia, First-degree Relatives and Healthy Controls: a Meta-analysis

Overview

Journal Schizophr Bull

Publisher Oxford University Press

Specialty Psychiatry

Date 2008 Nov 8

PMID 18990712

Citations 48

Authors

Jeroen P F Koning

Diederik E Tenback

Jim van Os

Andre Aleman

Rene S Kahn

Peter N van Harten

Affiliations

Soon will be listed here.

Abstract

Background: Several studies have reported the presence of dyskinesia and parkinsonism in antipsychotic-naive patients with schizophrenia as well as in their first-degree relatives. These movement disorders may therefore form an integral part of the illness and its (genetic) liability.

Method: A systematic search was conducted in the Medline, EMBASE, and PsychINFO databases to identify studies reporting on dyskinesia and parkinsonism assessed in antipsychotic-naive patients with schizophrenia (n = 213) and controls (n = 242) and separately in nonill first-degree relatives (n = 395) and controls (n = 379). Effect sizes were pooled using random-effect models to calculate odds ratios (ORs) to compare the risk of these movement disorders among patients and healthy relatives each with matched controls.

Results: Antipsychotic-naive schizophrenia was found to be strongly associated with dyskinesia (OR: 3.59, 95% confidence interval [CI]: 1.53-8.41) and parkinsonism (OR: 5.32, 95% CI: 1.75-16.23) compared with controls. Dyskinesia and parkinsonism were also significantly more prevalent in healthy first-degree relatives of patients with schizophrenia as compared with healthy controls (OR: 1.38, 95% CI: 1.06-1.81, and OR: 1.37, 95% CI: 1.05-1.79, respectively).

Conclusion: The results suggest that movement disorders, and by inference abnormalities in the nigrostriatal pathway, are not only associated with schizophrenia itself but may also be related to the (genetic) risk of developing the disease.

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References

Janno S, Holi M, Tuisku K, Wahlbeck K . Validity of Simpson-Angus Scale (SAS) in a naturalistic schizophrenia population. BMC Neurol. 2005; 5(1):5. PMC: 555761. DOI: 10.1186/1471-2377-5-5. View

Cortese L, Caligiuri M, Malla A, Manchanda R, Takhar J, Haricharan R . Relationship of neuromotor disturbances to psychosis symptoms in first-episode neuroleptic-naive schizophrenia patients. Schizophr Res. 2005; 75(1):65-75. DOI: 10.1016/j.schres.2004.08.003. View

Rossi A, de Cataldo S, Di Michele V, Manna V, Ceccoli S, Stratta P . Neurological soft signs in schizophrenia. Br J Psychiatry. 1990; 157:735-9. DOI: 10.1192/bjp.157.5.735. View

Kinney D, Yurgelun-Todd D, Woods B . Hard neurologic signs and psychopathology in relatives of schizophrenic patients. Psychiatry Res. 1991; 39(1):45-53. DOI: 10.1016/0165-1781(91)90007-c. View

Fish B, Marcus J, Hans S, AUERBACH J, Perdue S . Infants at risk for schizophrenia: sequelae of a genetic neurointegrative defect. A review and replication analysis of pandysmaturation in the Jerusalem Infant Development Study. Arch Gen Psychiatry. 1992; 49(3):221-35. DOI: 10.1001/archpsyc.1992.01820030053007. View

Andreasen N, Carpenter Jr W . Diagnosis and classification of schizophrenia. Schizophr Bull. 1993; 19(2):199-214. DOI: 10.1093/schbul/19.2.199. View

Caligiuri M, Lohr J, Jeste D . Parkinsonism in neuroleptic-naive schizophrenic patients. Am J Psychiatry. 1993; 150(9):1343-8. DOI: 10.1176/ajp.150.9.1343. View

Marcus J, Hans S, AUERBACH J, Auerbach A . Children at risk for schizophrenia: the Jerusalem Infant Development Study. II. Neurobehavioral deficits at school age. Arch Gen Psychiatry. 1993; 50(10):797-809. DOI: 10.1001/archpsyc.1993.01820220053006. View

Fleiss J . The statistical basis of meta-analysis. Stat Methods Med Res. 1993; 2(2):121-45. DOI: 10.1177/096228029300200202. View

10.

Caligiuri M, Lohr J . A disturbance in the control of muscle force in neuroleptic-naive schizophrenic patients. Biol Psychiatry. 1994; 35(2):104-11. DOI: 10.1016/0006-3223(94)91199-1. View

11.

McCreadie R, Ohaeri J . Movement disorder in never and minimally treated Nigerian schizophrenic patients. Br J Psychiatry. 1994; 164(2):184-9. DOI: 10.1192/bjp.164.2.184. View

12.

Sanders R, Keshavan M, Schooler N . Neurological examination abnormalities in neuroleptic-naive patients with first-break schizophrenia: preliminary results. Am J Psychiatry. 1994; 151(8):1231-3. DOI: 10.1176/ajp.151.8.1231. View

13.

Walker E . Developmentally moderated expressions of the neuropathology underlying schizophrenia. Schizophr Bull. 1994; 20(3):453-80. DOI: 10.1093/schbul/20.3.453. View

14.

Hernan Silva I, Jerez C, Ruiz T, Seguel L, Court L, Labarca B . [Lack of involuntary abnormal movements in untreated schizophrenic patients]. Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1994; 22(5):200-2. View

15.

Honer W, Kopala L, Rabinowitz J . Extrapyramidal symptoms and signs in first-episode, antipsychotic exposed and non-exposed patients with schizophrenia or related psychotic illness. J Psychopharmacol. 2005; 19(3):277-85. DOI: 10.1177/0269881105051539. View

16.

Chong S, Subramaniam M, Verma S . Spontaneous parkinsonism in antipsychotic-naive patients with first-episode psychosis. Can J Psychiatry. 2005; 50(7):429-31. DOI: 10.1177/070674370505000707. View

17.

Chen Y, Chen Y, Mak F . Soft neurological signs in schizophrenic patients and their nonpsychotic siblings. J Nerv Ment Dis. 2000; 188(2):84-9. DOI: 10.1097/00005053-200002000-00004. View

18.

Fenton W . Prevalence of spontaneous dyskinesia in schizophrenia. J Clin Psychiatry. 2000; 61 Suppl 4:10-4. View

19.

Glazer W . Review of incidence studies of tardive dyskinesia associated with typical antipsychotics. J Clin Psychiatry. 2000; 61 Suppl 4:15-20. View

20.

Boks M, Russo S, Knegtering R, van den Bosch R . The specificity of neurological signs in schizophrenia: a review. Schizophr Res. 2000; 43(2-3):109-16. DOI: 10.1016/s0920-9964(99)00145-0. View