Neuromotor abnormalities in neuroleptic-naive psychotic patients: antecedents, clinical correlates, and prediction of treatment response

BackgroundPrimary neuromotor abnormalities are thought to be a manifestation of the brain pathology underlying the psychotic illness; however, their causes and consequences are poorly understood. The study's aim was to examine the prevalence and correlates of neuromotor abnormalities in a sample of neuroleptic-naive psychotic patients.MethodOne hundred psychotic inpatients were rated for parkinsonism, catatonia, dyskinesia, and akathisia at the neuroleptic-naive state; and their association with demographic, antecedent, clinical, and treatment response variables was examined.ResultsNeurological syndromes tended to co-vary, and 34 of the patients had at least one categorically defined neurological syndrome. Higher ratings of parkinsonism, catatonia, and dyskinesia were associated with obstetric complications, poorer premorbid adjustment, more severe negative symptoms, higher prevalence of the deficit syndrome, and poorer response to antipsychotic drugs. Patients with schizophrenia had higher parkinsonism and dyskinesia ratings than those with other psychotic disorders.ConclusionsNeuromotor abnormalities represent both an integral part of the disease process not influenced by chronicity or antipsychotic drugs and a severity marker of the psychotic illness.