title: Abnormal movements in first-episode, nonaffective psychosis: dyskinesias, stereotypies, and catatonic-like signs.
abstract: Motor abnormalities represent a neurobehavioral domain of signs intrinsic to schizophrenia-spectrum disorders, though they are commonly attributed to medication side effects and remain understudied. Individuals with first-episode psychosis represent an ideal group to study innate movement disorders due to minimal prior antipsychotic exposure. We measured dyskinesias, stereotypies, and catatonic-like signs and examined their associations with: (1) age at onset of psychotic symptoms and duration of untreated psychosis; (2) positive, negative, and disorganized symptoms; (3) neurocognition; and (4) neurological soft signs. Among 47 predominantly African American first-episode psychosis patients in a public-sector hospital, the presence and severity of dyskinesias, stereotypies, and catatonic-like features were assessed using approximately 30-min video recordings. Movement abnormalities were rated utilizing three scales (Dyskinesia Identification System Condensed User Scale, Stereotypy Checklist, and Catatonia Rating Scale). Correlational analyses were conducted. Scores for each of three movement abnormality types were modestly inter-correlated (r=0.29-0.40). Stereotypy score was significantly associated with age at onset of psychotic symptoms (r=0.32) and positive symptom severity scores (r=0.29-0.41). There were no meaningful or consistent associations with negative symptom severity, neurocognition, or neurological soft signs. Abnormal movements appear to represent a relatively distinct phenotypic domain deserving of further research.
authors.affiliation: Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA; Hofstra North Shore-LIJ School of Medicine at Hofstra University, Department of Psychiatry, Hempstead, NY, USA. Electronic address: mcompton@nshs.edu.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Compton
authors.affiliation: Harvard Longwood Psychiatry Residency Training Program, Boston, MA, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Fantes
authors.affiliation: Tufts University School of Medicine, Physician Assistant Program, Boston, MA, USA.
authors.forename: Claire Ramsay
authors.initials: CR
authors.lastname: Wan
authors.affiliation: Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Johnson
authors.affiliation: Emory University Graduate School of Arts and Sciences, Department of Psychology, Atlanta, GA, USA.
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Walker
mesh_terms: D000328:Adult; D002389:Catatonia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D020820:Dyskinesias / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D011203:Poverty; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D019956:Stereotypic Movement Disorder / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D014741:Video Recording; D055815:Young Adult
keywords: Catatonia; Dyskinesias; First-episode psychosis; Movement abnormalities; Schizophrenia; Stereotypies