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Movement disorders in neuroleptic-naïve patients with schizophrenia spectrum disorders.

Ayehu M, Shibre T, Milkias B, Fekadu A - BMC Psychiatry (2014)

Bottom Line: Body mass index (BMI) was used as a proxy measure for nutritional status.BMI (OR = 0.6, 95% CI = 0.40, 0.89; p = 0.011) and increasing age (OR = 1.10; 95% CI = 1.02, 1.20; p = 0.017) were associated with SMD.This finding supports previous suggestions that abnormal involuntary movements in schizophrenia and other psychotic disorders may be related to the pathophysiology of psychotic disorders and therefore cannot be attributed entirely to the adverse effects of neuroleptic medication.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia. Abe.wassie@kcl.ac.uk.

ABSTRACT

Background: Spontaneous Movements Disorders (SMDs) or dyskinetic movements are often seen in patients with schizophrenia and other psychotic disorders, and are widely considered to be adverse consequences of the use of antipsychotic medications. Nevertheless, SMDs are also observed in the pre-neuroleptic ear and among patients who were never exposed to antipsychotic medications. The aim of this study was to determine the extent of SMDs among antipsychotic-naïve patients in a low income setting, and to evaluate contextually relevant risk factors.

Methods: The study was a cross-sectional facility-based survey conducted at a specialist psychiatric hospital in Addis Ababa, Ethiopia. Consecutive consenting treatment-naïve patients with a diagnosis of schizophrenia, schizoaffective disorder and schizophreniform disorder contacting services for the first time were assessed using the Simpson-Angus Rating Scale (SAS) and the Abnormal Involuntary Movement Scale (AIMS) to evaluate the presence of SMDS. Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) were administered to evaluate negative and positive symptom profiles respectively. Body mass index (BMI) was used as a proxy measure for nutritional status.

Result: Sixty-four patients, 67.2% male (n = 43), with first contact psychosis who met the DSM-IV-TR criteria for schizophrenia (n = 47), schizophreniform disorder (n= 5), and schizoaffective disorder (n = 12) were assessed over a two month study period. Seven patients (10.9%) had SMDs. BMI (OR = 0.6, 95% CI = 0.40, 0.89; p = 0.011) and increasing age (OR = 1.10; 95% CI = 1.02, 1.20; p = 0.017) were associated with SMD.

Conclusions: This finding supports previous suggestions that abnormal involuntary movements in schizophrenia and other psychotic disorders may be related to the pathophysiology of psychotic disorders and therefore cannot be attributed entirely to the adverse effects of neuroleptic medication.

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Related in: MedlinePlus

Proportion of participants with evidence of malnutrition according to the BMI-based WHO classification.
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Fig1: Proportion of participants with evidence of malnutrition according to the BMI-based WHO classification.

Mentions: Based on the WHO Expert Committee classification for Chronic Energy Deficiency in adults, close to half of the participants (n = 29; 45.3%) were in the underweight range with a BMI value of less than 18.5. Among those with low BMI values, 12 (41.4%) had BMI values of less than 16, which is classified as severely underweight. These details are presented in Figure 1. Thirty six (56.3%) participants had either current or past history of substance use (alcohol, khat, cigarettes or cannabis) and among those 52.4% of those used substances daily.Figure 1


Movement disorders in neuroleptic-naïve patients with schizophrenia spectrum disorders.

Ayehu M, Shibre T, Milkias B, Fekadu A - BMC Psychiatry (2014)

Proportion of participants with evidence of malnutrition according to the BMI-based WHO classification.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4195874&req=5

Fig1: Proportion of participants with evidence of malnutrition according to the BMI-based WHO classification.
Mentions: Based on the WHO Expert Committee classification for Chronic Energy Deficiency in adults, close to half of the participants (n = 29; 45.3%) were in the underweight range with a BMI value of less than 18.5. Among those with low BMI values, 12 (41.4%) had BMI values of less than 16, which is classified as severely underweight. These details are presented in Figure 1. Thirty six (56.3%) participants had either current or past history of substance use (alcohol, khat, cigarettes or cannabis) and among those 52.4% of those used substances daily.Figure 1

Bottom Line: Body mass index (BMI) was used as a proxy measure for nutritional status.BMI (OR = 0.6, 95% CI = 0.40, 0.89; p = 0.011) and increasing age (OR = 1.10; 95% CI = 1.02, 1.20; p = 0.017) were associated with SMD.This finding supports previous suggestions that abnormal involuntary movements in schizophrenia and other psychotic disorders may be related to the pathophysiology of psychotic disorders and therefore cannot be attributed entirely to the adverse effects of neuroleptic medication.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia. Abe.wassie@kcl.ac.uk.

ABSTRACT

Background: Spontaneous Movements Disorders (SMDs) or dyskinetic movements are often seen in patients with schizophrenia and other psychotic disorders, and are widely considered to be adverse consequences of the use of antipsychotic medications. Nevertheless, SMDs are also observed in the pre-neuroleptic ear and among patients who were never exposed to antipsychotic medications. The aim of this study was to determine the extent of SMDs among antipsychotic-naïve patients in a low income setting, and to evaluate contextually relevant risk factors.

Methods: The study was a cross-sectional facility-based survey conducted at a specialist psychiatric hospital in Addis Ababa, Ethiopia. Consecutive consenting treatment-naïve patients with a diagnosis of schizophrenia, schizoaffective disorder and schizophreniform disorder contacting services for the first time were assessed using the Simpson-Angus Rating Scale (SAS) and the Abnormal Involuntary Movement Scale (AIMS) to evaluate the presence of SMDS. Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) were administered to evaluate negative and positive symptom profiles respectively. Body mass index (BMI) was used as a proxy measure for nutritional status.

Result: Sixty-four patients, 67.2% male (n = 43), with first contact psychosis who met the DSM-IV-TR criteria for schizophrenia (n = 47), schizophreniform disorder (n= 5), and schizoaffective disorder (n = 12) were assessed over a two month study period. Seven patients (10.9%) had SMDs. BMI (OR = 0.6, 95% CI = 0.40, 0.89; p = 0.011) and increasing age (OR = 1.10; 95% CI = 1.02, 1.20; p = 0.017) were associated with SMD.

Conclusions: This finding supports previous suggestions that abnormal involuntary movements in schizophrenia and other psychotic disorders may be related to the pathophysiology of psychotic disorders and therefore cannot be attributed entirely to the adverse effects of neuroleptic medication.

Show MeSH
Related in: MedlinePlus