Schizophrenia with movement disorder prior to treatment

Abstract

Movement disorders are present in a subgroup of patients with schizophrenia prior to exposure to antipsychotic treatment, and may have implications for treatment response and outcome. As part of the Hong Kong First-Episode Psychosis Study, patients were assessed with the PANSS, Simpson–Angus, Barnes Akathisia and AIMS scales at presentation. We identified nine patients with movement disorders prior to any treatment. These patients and a comparison group of 36 patients with no movement disorder prior to treatment were reassessed at two later time points (mean 8 and 26 weeks later). At presentation, patients with movement disorders had higher negative symptom factor scores (0–6 scoring, 7 items, mean 14.6 vs. 9.3, p = 0.03). At the second and third assessments, all patients were being treated with antipsychotic medication (mean doses 438 and 302 mg CPZ equivalents), with no difference between groups at either time point. Among patients with movement disorders prior to treatment, these resolved in 3/9 at assessment two, and in 6r9 at assessment three. Considering all three time points, patients with movement disorders at baseline had higher total PANSS (p = 0.005), negative symptom factor (p = 0.003) and cognitive symptom factor (p = 0.04) scores. Positive symptom factor scores did not differ. In never-medicated patients with movement disorders, specific domains of symptomatology appear to be different when compared over time with patients who do not have movement disorders prior to treatment.