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Risk factors, pre-morbid functioning and episode correlates of neurological soft signs in drug-naive patients with schizophrenia-spectrum disorders

Published online by Cambridge University Press:  22 September 2010

V. Peralta ,
E. G. de Jalón ,
M. S. Campos ,
V. Basterra ,
A. Sanchez-Torres  and
M. J. Cuesta
V. Peralta*
Affiliation:
Psychiatry Section B, Complejo Hospitalario de Navarra, Pamplona, Spain
E. G. de Jalón
Affiliation:
Psychiatry Section B, Complejo Hospitalario de Navarra, Pamplona, Spain
M. S. Campos
Affiliation:
Psychiatry Section B, Complejo Hospitalario de Navarra, Pamplona, Spain
V. Basterra
Affiliation:
Psychiatry Section B, Complejo Hospitalario de Navarra, Pamplona, Spain
A. Sanchez-Torres
Affiliation:
Psychiatry Section B, Complejo Hospitalario de Navarra, Pamplona, Spain
M. J. Cuesta
Affiliation:
Psychiatry Section B, Complejo Hospitalario de Navarra, Pamplona, Spain
*
*Address for correspondence: V. Peralta, M.D., Ph.D., Psychiatry Section B, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008 Pamplona, Spain. (Email: victor.peralta.martin@cfnavarra.es)
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Abstract

Background

There is a lack of consistent evidence regarding associations of neurological soft signs (NSS) with illness-related variables in schizophrenia. This study examined NSS in first-episode psychotic patients with respect to their factor structure and associations with risk factors, pre-morbid characteristics, psychopathology and spontaneous extrapyramidal syndromes.

Method

First-episode, drug-naive patients with schizophrenia-spectrum disorders (n=177) were assessed for NSS using the Neurological Evaluation Scale, and its 26 constituting items were factor analysed. The identified neurological dimensions were then entered into hierarchical regression models as outcome dependent variables of a set of predictors including risk factors (familial loading for schizophrenia, obstetric complications), pre-morbid characteristics (neurodevelopmental delay, symptoms of attention deficit–hyperactivity disorder, pre-morbid functioning), psychopathological domains (reality distortion, disorganization, negative symptoms, mania, depression, catatonia) and spontaneous extrapyramidal syndromes (parkinsonism, dyskinesia, akathisia).

Results

Five neurological domains were identified: sequencing, release signs, sensory integration, abnormal movements and coordination. Multivariate analyses showed independent associations (p<0.01) of sequencing with familial liability to schizophrenia, deterioration of pre-morbid adjustment and parkinsonism; release signs with obstetric complications, catatonic symptoms and parkinsonism; sensory integration with familial liability to schizophrenia; abnormal movements with familial liability to schizophrenia, obstetric complications, parkinsonism and dyskinesia; and coordination with neurodevelopmental delay. The empirically derived factors explained additional variance over and above that explained by subscale scores across the examined variables.

Conclusions

Familial liability to schizophrenia, obstetric complications, neurodevelopmental delay, deterioration in pre-morbid functioning and observable motor disorders appear to contribute independently to domains of neurological dysfunction. The findings support a neurodevelopmental model of NSS in schizophrenia.

Keywords

Extrapyramidal symptomsneurodevelopmentneurological soft signspsychopathologyschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 6 , June 2011 , pp. 1279 - 1289
Copyright
Copyright © Cambridge University Press 2010

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