An exploratory study from eastern India on neurological soft signs and spontaneous movement disorders in schizophrenia spectrum disorders

Open J Psychiatry Allied Sci. 2019 Jan-Jun;10(1):3-8. doi: 10.5958/2394-2061.2019.00001.6. Epub 2019 Jan 16.


Background: Apart from the traditional symptoms of delusion and hallucination, soft signs of neurological dysfunction in psychotic disorder has the potential for addressing neurodevelopmental and neurodegenerative aetiology.

Aim: The study explored the neurological soft signs (NSS) and spontaneous movement disorders (SMD) in the same patient population of schizophrenia spectrum disorder (SSD) and other psychotic disorders.

Materials and methods: Patients were diagnosed with SSD and other psychotic disorders as per ICD-10 diagnostic criteria and were evaluated with the Heidelberg manual for NSS and Modified Abnormal Involuntary Movement Scale (AIMS), Simpson-Angus Rating Scale (SARS), Barnes Akathisia Rating Scale (BARS) for assessing dyskinesia.

Results: Total 16 patients with mean age of 28.7 (±7.7) years had a mean duration of 63.2 (±68.8) months' disorder. Patients with schizophrenia had the mean Heidelberg score of 6.75 (±3.304). The scores of complex motor task, right/ left spatial orientation, integrative functions, and hard signs varied but the motor coordination score was unwaveringly high in all the participants with SSD. Sixty six per cent of SSD patients had dyskinesia. None had scored more than the upper limit of normal range in SARS. None of the participants had scored enough to qualify for akathisia.

Conclusion: NSS and SMD emerge as distinct objective parameters for a group of psychotic disorder patients, especially SSD.

Keywords: Abnormal Involuntary Movement Scale; Dyskinesia; Motor Coordination; Psychotic Disorders.