Quantitative motor activity differentiates schizophrenia subtypes.
BACKGROUND
Motor symptoms are frequent in schizophrenia and relevant to the diagnosis of subtypes. However, the assessment has been limited to observations recorded in scales and experimental designs. The aim of this study was to use wrist actigraphy to obtain motor activity data in 3 schizophrenia subtypes.


METHODS
In total, 60 patients with schizophrenia (35 paranoid, 12 catatonic, 13 disorganized) were investigated using continuous wrist actigraphy over 24 h in an inpatient setting on average 38 days after admission. Data of the wakeful hours of the day were analyzed.


RESULTS
The activity level was predicted by schizophrenia subtype and by the type of antipsychotic medication. The movement index and mean duration of uninterrupted immobility were found to be predicted only by the schizophrenia subtype. Age, gender, duration of illness and chlorpromazine equivalents did not contribute to the variance of the activity data. A MANOVA demonstrated the significant differences in the 3 parameters between schizophrenia subtypes (p = 0.001). Patients with catatonic schizophrenia had lower activity levels, a lower movement index and a longer duration of immobility than those with paranoid schizophrenia.


CONCLUSIONS
Schizophrenia subtypes can be differentiated using objective measures of quantitative motor activity. The increased duration of immobility appears to be the special feature of catatonic schizophrenia.
Walther
Sebastian
S
University Hospital of Psychiatry, University of Bern, Bern, Switzerland. walther@puk.unibe.ch
Horn
Helge
H
Razavi
Nadja
N
Koschorke
Philipp
P
Müller
Thomas J
TJ
Strik
Werner
W
D056044:Actigraphy; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D015999:Multivariate Analysis; D012560:Schizophrenia, Catatonic / Q000175:diagnosis* / Q000188:drug therapy; D012562:Schizophrenia, Disorganized / Q000175:diagnosis* / Q000188:drug therapy; D012563:Schizophrenia, Paranoid / Q000175:diagnosis* / Q000188:drug therapy; D012720:Severity of Illness Index; D012890:Sleep; D013997:Time Factors; D014851:Wakefulness; D014953:Wrist
D014150:Antipsychotic Agents