Gervin M, Browne S, Lane A, Clarke M, Waddington J L, Larkin C, O'Callaghan E
Theodore and Vada Stanley Research Unit, Cluain Mhuire Services, Hospitaller Order of St. John of God, Dublin, Ireland.
Am J Psychiatry. 1998 Sep;155(9):1202-6. doi: 10.1176/ajp.155.9.1202.
This study investigated the rate of spontaneous abnormal involuntary movements in a group of patients presenting with a first episode of schizophrenia or schizophreniform psychosis.
Seventy-nine patients with a first episode of schizophrenia or schizophreniform psychosis who presented to a catchment area psychiatric service over a 3-year period, and who were neuroleptic-naive or had been medicated for less than 1 month, were examined for the presence of involuntary movements with use of the Abnormal Involuntary Movement Scale.
Six patients (7.6%) had spontaneous dyskinesia as defined by the criteria of Schooler and Kane, and nine other patients had mild orofacial involuntary movements. The patients with spontaneous dyskinesia had completed significantly fewer years of education than the patients without dyskinesia. Spontaneous involuntary movements were unrelated to age at presentation for treatment.
Spontaneous abnormal involuntary movements were evident among a proportion of patients with first-episode schizophrenia or schizophreniform psychosis at baseline presentation and were associated with reduced educational attainment. This finding supports previous suggestions that abnormal involuntary movements in schizophrenia may be related to the pathophysiology of the illness and therefore cannot be attributed entirely to the adverse effects of neuroleptic medication.
本研究调查了一组首次发作精神分裂症或精神分裂症样精神病患者的自发异常不自主运动发生率。
在3年期间，对79例首次发作精神分裂症或精神分裂症样精神病且前来某地区精神病服务机构就诊的患者进行检查，这些患者未曾使用过抗精神病药物或用药时间少于1个月，使用异常不自主运动量表检测其是否存在不自主运动。
按照斯库勒和凯恩的标准，6例患者（7.6%）存在自发运动障碍，另外9例患者存在轻度口面部不自主运动。有自发运动障碍的患者受教育年限显著少于无运动障碍的患者。自发不自主运动与开始治疗时的年龄无关。
在首次发作精神分裂症或精神分裂症样精神病患者中，一部分患者在基线检查时存在明显的自发异常不自主运动，且与受教育程度降低有关。这一发现支持了先前的观点，即精神分裂症中的异常不自主运动可能与疾病的病理生理学有关，因此不能完全归因于抗精神病药物的不良反应。
