Department of Psychiatry, Complejo Hospitalario de Navarra, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain.
Mental Health Department of Servicio Navarro de Salud, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain.
Schizophr Res. 2018 Oct;200:97-103. doi: 10.1016/j.schres.2017.08.050. Epub 2017 Sep 8.
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 6months 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 6months 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.
运动异常（MAs）在首发精神病患者中非常普遍，无论是在接触抗精神病药物之前还是之后。然而，这些异常对长期社会心理功能的预测价值尚不清楚。100 名未经抗精神病药物治疗的首发精神病（FEP）患者接受了广泛的运动评估，包括紧张症、帕金森病、运动障碍、静坐不能和神经软体征。患者在未用药状态下和 6 个月后进行评估。患者在自然治疗环境中接受随访，从 FEP 开始的 6 个月、1 年、5 年和 10 年收集所有可用信息评估他们的社会心理功能。建立了一组线性混合模型，以考虑在随访期间对运动异常的五个领域（紧张症、帕金森病、静坐不能、运动障碍和神经软体征）进行重复的纵向评估，包括在指数发作时处于抗精神病药物未用药状态和 FEP 后 6 个月。基本的流行病学变量、精神分裂症诊断和抗精神病药物的氯丙嗪等效剂量平均值被纳入协变量。在未用药状态下的紧张症和运动障碍与长期社会心理功能不良显著相关。此外，FEP 6 个月时的帕金森病、静坐不能、神经软体征和紧张症评分较高，但运动障碍评分较低，与长期社会心理功能不良显著相关。我们的研究结果为抗精神病药物治疗前后的运动异常作为精神病核心表现提供了实证依据，并具有较高的预测价值，可预测 FEP 患者的长期社会心理功能不良。
