title: [Minor neurological and physical anomalies in patients with first-episode psychosis].
abstract: BACKGROUND
  Over the last several decades, there has been an increasing number of neuroanatomical, neuroimaging, neurophysiological, and neuropsychological studies in search of structural, functional, and cognitive correlates of brain insult(s) that could ultimately lead to unravelling the pathophysiology of schizophrenia. A direct, easily administered, and inexpensive way of investigating brain dysfunction in schizophrenia is the study of neurological soft signs and minor physical anomalies, two putative indices of developmental abnormality. The study of these neurodevelopmental markers in the first-episode psychosis allows the detection of the neurodevelopmental abnormalities at the onset of psychosis.
  
  
  OBJECTIVE
  The objectives of our study were to determinate the prevalence, the scores, and the nature of neurological soft signs (NSS) and minor physical anomalies (MPA) in patients with first-episode psychosis and to explore the correlations between these neurodevelopmental markers and the demographic, clinical and therapeutic features.
  
  
  METHODS
  A cross-sectional study was carried-out on 61 patients (mean age: 28.9±9.4years; 86.9% were males), hospitalized for first-episode psychosis (DSM-IV-TR diagnosis of schizophrenia, schizophreniform disorder, brief psychotic disorder, delusional disorder, and psychotic disorder not otherwise specified). The evaluation procedure consisted of a retrospective assessment of the premorbid functioning by the Premorbid Functioning Scale (PAS) and the following clinical scales: Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF), the NSS scale of Krebs et al. (23 items exploring motor coordination, motor integrative function, sensory integration, involuntary movements or posture, quality of lateralization) and the MPA scale of Gourion et al. (41 items, exploring anomalies of face, eyes, ears, mouth, hands and feet).
  
  
  RESULTS
  The prevalence of NSS was 83.6% (cut-off point=9.5), with a mean total score of 15.3±6.7. The highest score was for the motor coordination. The prevalence of MPA was 62.7% (cut-off point=5), with a mean total score of 5.8±3.2. The most common MPA were the fine hair (50.8%), adherent earlobes (49.2%) and clinodactyly (31.1%). Correlations were found between the NSS total score and the Poor Premorbid Functioning (r=0.32, P=0.04), the PANSS total score (r=0.36, P=0.005), and the negative (r=0.45, P<0.001) and disorganization sub-scores (r=0.41, P=0.001), the CGI-severity of (r=0.30, P=0.02), the impairment functioning in the GAF (r=-0.26, P=0.04) and with extrapyramidal symptoms (r=0.52, P<0.001). However, no correlation was found between the NSS total scores, age, gender, the PANSS positive sub-score, the daily dosage of antipsychotics, the CGI-improvement score and the MPA total score. There was no correlation between MPA total score and demographic, clinical and therapeutic features of patients. Moreover, there was no correlation between the NSS or MPA scores and the short-term evolution (6months to 1year) towards schizophrenia.
  
  
  CONCLUSIONS
  These results confirm the data in the literature relating high NSS and MPA scores in patients with a first-episode psychosis. The NSS appear to characterize severe psychotic disorders with more negative and disorganization symptoms and poor social functioning and may be a prognostic indicator.
authors.affiliation: Service de psychiatrie, CHU de Monastir, rue 1(er)-Juin, 5000 Monastir, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Mhalla
authors.forename: N
authors.initials: N
authors.lastname: Boussaïd
authors.forename: L
authors.initials: L
authors.lastname: Gassab
authors.forename: L
authors.initials: L
authors.lastname: Gaha
authors.forename: A
authors.initials: A
authors.lastname: Mechri
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001259:Ataxia / Q000175:diagnosis / Q000453:epidemiology; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D012920:Social Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents