Prevalence of spontaneous dyskinesia in first episode, drug naive schizophrenia, and its relation to the positive and negative symptoms of schizophrenia

Abstract

Aims and objectives: This study aims to assess the prevalence of abnormal involuntary movement in never medicated patients with schizophrenia and to find its relation with demographic variables, and with the positive and negative symptoms of schizophrenia; this study also aims to assess the topography of the dyskinesia. Methodology: Socio-demographic data of 100 consecutively selected patients who fulfilled the ICD-10 Diagnostic Criteria for Research were collected in a 12-month period. These patients were rated with the Positive And Negative Syndrome Scale (PANSS) and Abnormal Involuntary Movement Scale (AIMS). Patients were labeled as having spontaneous dyskinesia if they fulfilled the criteria of Schooler and Kane which needs a score of two (mild) in at least two areas or score of three (moderate) or four (severe) in one area. Results: Fifty two per cent of the study samples were male and 48% were female with mean age of 30.72 years with standard deviation of 8.7 years. Sixteen per cent of the patients had dyskinesia when examined with AIMS. However, only 14% fulfilled the Schooler and Kane’s criteria for spontaneous dyskinesia. A strong correlation was found between the presence of dyskinesia and negative symptoms of schizophrenia. 57.1% of these 14 patients had dyskinesia located in their oral and facial region. Seventy one per cent of these patients with dyskinesia had no awareness of their involuntary movements. Conclusions: Spontaneous dyskinesia, negative symptoms, and lack of awareness of the abnormal involuntary movement can be taken as one of the presenting symptoms of schizophrenia.

An exploratory study from eastern India on neurological soft signs and spontaneous movement disorders in schizophrenia spectrum disorders

“…The mean age of the participants in this pilot study was 28.7 years which is similar to the studies done previously in first episode SSD from this region[10,24,25] as well as other parts of the world. [28,29] However, the age at the first psychiatric consultation depends on many factors like knowledge and attitude towards mental illness,[28] availability of mental health services, etc.…”

“…According to the criteria, a score of two (mild) in at least two areas or a score of three (moderate) or four (severe) in one area is the requisite. This is slightly lower than that found by Bhandari and Bhagabati[10] which was 14%. This difference is because of very small sample size in the current study.…”

“…This study from the eastern part of India assessed both NSS and SMD in the same participants with SSD and other diagnosis. Earlier from this region, Bhandari and Bhagabati[10] and Sharma and Nath[25,26] had explored SMD and NSS in patients with psychotic disorders respectively.…”

“…However, recent findings suggest that dyskinesia may be one of the features of schizophrenia as many studies have found patients with schizophrenia who are not exposed to antipsychotics, yet have dyskinesia and parkinsonian signs. [10–12] Reports of abnormal involuntary movement date from the first description of the illness; long before the introduction of chlorpromazine in 1952, Kraeplin gave the description of the involuntary movement in patients with schizophrenia. He wrote: “The spasmodic phenomena in the musculature of the face and of speech which often appear are extremely peculiar disorders.…”

Uncommon buccolingual masticatory syndrome: Antipsychotic medicine not only allows you to live a normal life, but it also increases the risk of physical changes

“…A condition known as tardive dyskinesia affects those on long-term dopaminergic antagonist drugs and involves uncontrollable movements of the tongue, lips, face, trunk, and extremities [8]. Dopamine, a brain neurotransmitter that helps regulate muscular action, is blocked by rst-generation antipsychotic medicines [9]. The patient in this case report had a two-day history of backward orofacial movement, chewing and masticatory di culties, speech impediment, and exhaustion.…”