Posted by Larry Hoover on March 1, 2008, at 17:36:58
In reply to TD? What TD?, posted by Jamal Spelling on February 25, 2008, at 14:36:39
I'm aware of considerable subsequent work verifying the presence of dyskinesia in unmedicated schizophrenics. Full-text on the final piece lets you check references, etc.
Lar
Br J Psychiatry. 1996 Feb;168(2):221-6.
Abnormal movements in never-medicated Indian patients with schizophrenia.
McCreadie RG, Thara R, Kamath S, Padmavathy R, Latha S, Mathrubootham N,
Menon MS.Clinical Research, Crichton Royal Hospital, Dumfries.
BACKGROUND: Historical records suggest dyskinesia was observed in severely
ill institutionalised patients with schizophrenia in the pre-neuroleptic
era. More recent work has not found dyskinesia in never-medicated younger
and middle aged patients. The present study complements this recent work and
avoids the confounders of severity of illness and institutionalism by
examining elderly patients in a wide variety of community settings. METHOD:
Movement disorders were examined in 308 elderly individuals in Madras,
India, using the Abnormal Involuntary Movements Scale, the Simpson and Angus
Parkinsonism Scale and the Barnes Akathisia Scale. Patients' mental state
was assessed by the Positive and Negative Syndrome Scale. RESULTS:
Dyskinesia was found in 15% of normal subjects (n = 101, mean age 63 years),
15% of first degree blood relatives of younger schizophrenic patients (n =
103, mean age 63 years), 38% of never medicated patients (n = 21, mean age
65 years) and 41% of medicated patients (n = 83, mean age 57 years). The
respective prevalences for Parkinsonism were 6%, 11%, 24% and 36%; and for
akathisia 9%, 5%, 21% and 23%. Dyskinesia was associated with negative
schizophrenic symptoms. CONCLUSIONS: Dyskinesia in elderly schizophrenic
patients is an integral part of the illness and not associated with
antipsychotic medication.J Clin Psychiatry. 2000;61 Suppl 4:10-4.
Prevalence of spontaneous dyskinesia in schizophrenia.
Fenton WS.
Chestnut Lodge Hospital, Rockville, MD 20850, USA. WSFMD@AOL.COM
Spontaneous abnormal involuntary movements phenomenologically identical to
neuroleptic-induced tardive dyskinesia have been described in schizophrenia
for over a century. Because at present nearly all patients with
schizophrenia are exposed to neuroleptic medications, information about the
prevalence of spontaneous dyskinesia is obtained from accounts from the
preneuroleptic era, evaluations of first-episode patients before neuroleptic
treatment, and the identification and assessment of drug-naive patients in
developing countries. In this report, data from 14 studies of
neuroleptic-naive patients with schizophrenia are used to generate
age-adjusted estimates of the prevalence of spontaneous dyskinesia. While
the precision of this estimate is limited by the difficulty of obtaining
large, untreated samples, available data suggest a spontaneous dyskinesia
rate of approximately 4% in first-episode schizophrenic patients, 12% for
patients ill several years but below age 30 years, 25% for those aged
between 30 and 50 years, and 40% for those aged 60 years or older. Relative
to the incidence and accrued prevalence of spontaneous dyskinesia expected
during the natural history of untreated schizophrenia, the cumulative impact
of treatment with new neuroleptic agents has yet to be determined.J Psychiatr Res. 2005 May;39(3):261-6.
Extrapyramidal symptoms in unmedicated schizophrenia.
McCreadie RG, Srinivasan TN, Padmavati R, Thara R.
Crichton Royal Hospital, Dumfries, DG1 4XB, Scotland, UK.Studies of spontaneous extrapyramidal symptoms, dyskinesia and parkinsonism, in unmedicated schizophrenia are of importance in understanding their underlying pathology and relation to the psychosis. This is a study of extrapyramidal symptoms using Abnormal Involuntary Movements Scale for dyskinesia and Simpson-Angus Scale for parkinsonism in 143 schizophrenia patients who never received antipsychotic medication. Psychopathology was measured using the Positive and Negative Syndrome Scale. Dyskinesia was present in 35% of patients and parkinsonism in 15%. The two disorders coexisted in 11 subjects. Orofacial dyskinesia, rigidity and tremor were common symptoms noted. There was no significant change in the rates and total scores of dyskinesia and parkinsonism with gender, age, duration of illness or age at onset of psychosis. Dyskinesia was unrelated to psychopathology. Parkinsonism score correlated positively with the motor symptom cluster of psychopathology. Dyskinesia and parkinsonism scores correlated positively with each other and parkinsonism score discriminated presence of dyskinesia. The associations between the spontaneous abnormal movements and other aspects of schizophrenia differed from those described in treated patients. Dyskinesia and parkinsonism are an integral part of the schizophrenia disease process whose relationship with other factors could be influenced by antipsychotic drug treatment.
Br J Psychiatry. 2002 Aug;181:135-7. Full-text: http://bjp.rcpsych.org/cgi/content/full/181/2/135
Spontaneous dyskinesia and parkinsonism in never-medicated, chronically ill patients with schizophrenia: 18-month follow-up.
McCreadie RG, Padmavati R, Thara R, Srinivasan TN.
Crichton Royal Hospital, Dumfries, UK. rgmccreadie_crh@compuserve.comBACKGROUND: Spontaneous dyskinesia and parkinsonism have been reported in never-medicated patients with schizophrenia but there has been no previous study of the natural history of these conditions. AIMS: To determine the prevalence of spontaneous dyskinesia and parkinsonism in a group of never-medicated, chronically ill patients with schizophrenia on two occasions separated by an 18-month interval. METHOD: Dyskinesia was assessed by the Abnormal Involuntary Movements Scale using Schooler and Kane criteria for its presence; parkinsonism by the Simpson and Angus scale; and mental state by the Positive and Negative Syndrome Scale for schizophrenia. RESULTS: Thirty-seven patients were examined on two occasions. Nine (24%) had dyskinesia on both occasions, 12 (33%) on one occasion and 16 (43%) on neither occasion. Twenty-one (57%) had dyskinesia on at least one occasion. Thirteen patients (35%) had parkinsonism on at least one occasion. CONCLUSIONS: Spontaneous dyskinesia and parkinsonism fluctuate over time. The former was found on at least one occasion in the majority of patients. It is an integral part of the schizophrenic disease process.
poster:Larry Hoover
thread:814622
URL: http://www.dr-bob.org/babble/neuro/20080204/msgs/815596.html