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Neurological soft signs and their relationship to 1-year outcome in first-episode schizophrenia

Published online by Cambridge University Press:  16 April 2020

Radovan Prikryl ,
Eva Ceskova ,
Tomas Kasparek  and
Hana Kucerova
Radovan Prikryl*
Affiliation:
Department of Psychiatry, Masaryk University, Faculty of Medicine and Faculty Hospital, Jihlavska 20, 625 00Brno, Czech Republic
Eva Ceskova
Affiliation:
Department of Psychiatry, Masaryk University, Faculty of Medicine and Faculty Hospital, Jihlavska 20, 625 00Brno, Czech Republic
Tomas Kasparek
Affiliation:
Department of Psychiatry, Masaryk University, Faculty of Medicine and Faculty Hospital, Jihlavska 20, 625 00Brno, Czech Republic
Hana Kucerova
Affiliation:
Department of Psychiatry, Masaryk University, Faculty of Medicine and Faculty Hospital, Jihlavska 20, 625 00Brno, Czech Republic
*
*Corresponding author. Tel.: +42 0532232055; fax: +42 0532233706. E-mail address: radovan.prikryl@post.cz (R. Prikryl).
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Abstract

Objectives

To examine the relationship between the severity of neurological soft signs at onset and at the 1-year follow-up of patients with schizophrenia, and to investigate temporal stability of neurological soft signs within 1 year from the onset of the first episode schizophrenia.

Methods

The study included 92 first-episode male schizophrenic patients. Neurological soft signs were assessed on the Neurological Evaluation Scale (NES) during index hospitalization and at a 1-year follow-up. The patients were divided into remitters and non-remitters according to their psychiatric status assessed at the 1-year follow-up, using the Positive and Negative Syndrome Scale (PANSS).

Results

A trend for a lower score for the NES item “others” in late remitters versus non-remitters at baseline was found during index hospitalization. At the 1-year follow-up, the overall severity of the neurological soft signs was statistically significantly higher in non-remitters than in remitters. Within 1 year after index hospitalization, a significant reduction of neurological soft signs, with the exception of sensory integration, occurred in remitters. Within 1 year after index hospitalization, the non-remitters reported a significant reduction of the overall NES score.

Conclusion

These findings in a population of patients with first episode schizophrenia are in accord with the findings of previous studies which found an association between neurological soft signs, treatment response and outcome. This association may characterize a subgroup of patients with a poor course of illness and outcome. Neurological soft signs might be regarded as one of the indicators of treatment outcome in patients suffering from their first episode of schizophrenia.

Keywords

First episodeNeurologySchizophreniaSoft signs
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 8 , November 2007 , pp. 499 - 504
Copyright
Copyright © Elsevier Masson SAS 2007

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References

Andreasen, N.C., Carpenter, W.T. Jr., Kane, J.M., Lasse, R.A., Marder, S.R., Weinberger, D.R.Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005;162:441–449.CrossRefGoogle ScholarPubMed
Bachman, S., Bottmer, C.H., Schroder, J.Neurological soft signs in first-episode schizophrenia: a follow-up study. Am J Psychiatry 2005;162:2337–2343.CrossRefGoogle Scholar
Browne, S., Clarke, M., Gervin, M., Lane, A., Waddington, J.L., Larkin, C.et al.Determinants of neurological dysfunction in first episode schizophrenia. Psychol Med 2000;30:1433–1441.CrossRefGoogle ScholarPubMed
Buchanan, R.W., Heinrichs, D.W.The neurological evaluation scale (NES): a structured instrument for the assessment of neurological signs of schizophrenia. Psychiatry Res 1989;27:335–350.CrossRefGoogle ScholarPubMed
Buchanan, R.W., Koeppl, P., Brier, A.Stability of neurological signs with clozapine treatment. Biol Psychiatry 1994;36:198–200.CrossRefGoogle ScholarPubMed
Chen, E.Y., Hui, C.H.L., Chan, R.C.H., Dunn, E.L., Miao, M.Y., Yeung, W.S.et al.A 3-year prospective study of neurological soft signs in first-episode schizophrenia. Schizophr Res 2005;75:45–54.CrossRefGoogle ScholarPubMed
Dazzan, P., Morgan, K.D., Orr, K.G., Hutchinson, G., Chitnis, X., Suckling, J.et al.The structural brain correlates of neurological soft signs in AESOP first-episode psychoses study. Brain 2004;127:143–153.CrossRefGoogle ScholarPubMed
Dazzan, P., Murray, R.M.Neurological soft signs in first-episode psychosis: a systematic review. Br J Psychiatry 2002;43:50–57.CrossRefGoogle ScholarPubMed
Emsley, R., Turner, H.J., Oosthuizen, P.P., Carr, J.Neurological abnormalities in first-episode schizophrenia: temporal stability and clinical and outcome correlates. Schizophr Res 2005;75:35–44.CrossRefGoogle ScholarPubMed
Gupta, S., Andreasen, N.C., Arndt, S., Flaum, M., Schultz, S.K., Hubbard, W.C.et al.Neurological soft signs in neuroleptic-naive and neuroleptic treated schizophrenic patients and in normal comparison subjects. Am J Psychiatry 1995;152:191–196.Google ScholarPubMed
Griffiths, T.D., Sigmundsson, T., Takei, N.Neurological abnormalities in familiar and sporadic schizophrenia. Brain 1998;121:191–203.CrossRefGoogle Scholar
Heinrichs, D.W., Buchanan, R.W.Significance and meaning of neurological signs in schizophrenia. Am J Psychiatry 1988;145:528–537.Google Scholar
International Statistical Classification of Diseases and Related Health Problems, 1989 Revision. Geneva: World Health Organization; 1992.Google Scholar
Johnstone, E.C., Macmillan, J.F., Frith, C.D., Bennm, D.K., Crow, T.J.Further investigation of the predictors of outcome following first schizophrenic episodes. Br J Psychiatry 1990;157:182–189.CrossRefGoogle ScholarPubMed
Kay, S., Fiszbein, A., Opler, L.A.The positive and negative syndrome scale for schizophrenia. Schizophr Bull 1987;13:261–278.CrossRefGoogle Scholar
Keshavan, M.S., Sanders, R.D., Sweeney, J.A., Diwadkar, V.A., Goldstein, G., Pettegrew, J.W.et al.Diagnostic specificity and neuroanatomical validity of neurological abnormalities in first-episode psychoses. Am J Psychiatry 2003;160:1298–1304.CrossRefGoogle ScholarPubMed
Kucerova, H., Prikryl, R., Spacek, J., Kasparek, T., Ceskova, E.Neurologické mekke priznaky a kognitivni dysfunkce u schizofrenie. Psychiatrie. časopis pro moderní psychiatrii 2003;supplementum 2:51–53.Google Scholar
Madsen, A.L., Vorstrup, S., Rubin, P.Neurological abnormalities in schizophrenic patients: a prospective follow-up study 5 years after first admission. Acta Psychiatr Scand 1999;100:119–125.CrossRefGoogle ScholarPubMed
Ovsiew, F.Bedside neuropsychiatry: eliciting the clinical phenomena of neuropsychiatric illness. In: Yudovsky, S.C., Hales, R.E. editors. Synopsis of Neuropsychiatry. Washington, DC: American Psychiatric Press; 1994. p. 77–106.Google Scholar
Prikryl, R., Ceskova, E., Kasparek, T., Kucerova, H.Neurological soft signs, clinical symptoms and treatment reactivity in patients suffering from first episode schizophrenia. J Psychiatr Res 2006;40:141–146.CrossRefGoogle ScholarPubMed
Rubin, P., Vostrup, S., Hemmingsen, R., Andersen, H.S., Bendsen, B.B., Strømsø, N.et al.Neurological abnormalities in patients with schizophrenia or schizophreniform disorder at first admission to hospital: correlation with computerized tomography and regional cerebral blood flow findings. Acta Psychiatr Scand 1994;90:385–390.CrossRefGoogle ScholarPubMed
Sanders, R.D., Keshavan, M.S., Schooler, N.R.Neurological examination abnormalities in neuroleptic-naive patients with first-break schizophrenia: preliminary results. Am J Psychiatry 1994;151:1231–1233.Google ScholarPubMed
Schroder, J., Niethammer, R., Geider, F.J., Reitz, C., Binkert, M., Jauss, M.et al.Neurological soft signs in schizophrenia. Schizophr Res 1992;6:25–30.CrossRefGoogle Scholar
Smith, R.C., Kadewari, R.P.Neurological soft signs and response to risperidone in chronic schizophrenia. Biol Psychiatry 1996;40:1056–1059.CrossRefGoogle ScholarPubMed
Smith, R.C., Hussain, M.I., Chowdhury, S.A.Stability of neurological soft signs in chronically hospitalized schizophrenic patients. J Neuropsychiatry Clin Neurosci 1996;11:91–96.CrossRefGoogle Scholar
Torrey, E.G.Neurological abnormalities in schizophrenic patients. Biol Psychiatry 1980;15:381–388.Google ScholarPubMed
Tucker, G.J., Silberfarb, P.M.Neurologic dysfunction in schizophrenia: significance for diagnostic practice. In: Akistal, H., Webb, W. editors. Psychiatric Diagnosis: Exploration of Biological Predictors. New York: Spektrum; 1978. p. 453–462.Google Scholar
Whitty, P., Clarke, M., Browne, S., McTigue, O., Kamali, M., Feeney, L.et al.Prospective evaluation of neurological soft signs in first episode-schizophrenia in relation to psychopathology: state versus trait phenomena. Psychol Med 2003;33:1479–1484.CrossRefGoogle ScholarPubMed
Woods, S.W.Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry 2003;64:663–667.CrossRefGoogle ScholarPubMed
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