Extrapyramidal symptoms and signs in first-episode, antipsychotic exposed and non-exposed patients with schizophrenia or related psychotic illness.
Identifieur interne : 002981 ( Main/Exploration ); précédent : 002980; suivant : 002982Extrapyramidal symptoms and signs in first-episode, antipsychotic exposed and non-exposed patients with schizophrenia or related psychotic illness.
Auteurs : William G. Honer [Canada] ; Lili C. Kopala ; Jonathan RabinowitzSource :
- Journal of psychopharmacology (Oxford, England) [ 0269-8811 ] ; 2005.
English descriptors
- KwdEn :
- Adolescent, Adult, Akathisia, Drug-Induced (epidemiology), Akathisia, Drug-Induced (physiopathology), Antipsychotic Agents (adverse effects), Antipsychotic Agents (therapeutic use), Basal Ganglia Diseases (chemically induced), Basal Ganglia Diseases (epidemiology), Basal Ganglia Diseases (physiopathology), Double-Blind Method, Female, Haloperidol (adverse effects), Haloperidol (therapeutic use), Humans, Male, Middle Aged, Parkinson Disease (epidemiology), Parkinson Disease (physiopathology), Psychotic Disorders (complications), Psychotic Disorders (drug therapy), Risk Factors, Risperidone (adverse effects), Risperidone (therapeutic use), Schizophrenia (complications), Schizophrenia (drug therapy), Social Behavior.
- MESH :
- chemical , adverse effects : Antipsychotic Agents, Haloperidol, Risperidone.
- chemically induced : Basal Ganglia Diseases.
- complications : Psychotic Disorders, Schizophrenia.
- drug therapy : Psychotic Disorders, Schizophrenia.
- epidemiology : Akathisia, Drug-Induced, Basal Ganglia Diseases, Parkinson Disease.
- physiopathology : Akathisia, Drug-Induced, Basal Ganglia Diseases, Parkinson Disease.
- chemical , therapeutic use : Antipsychotic Agents, Haloperidol, Risperidone.
- Adolescent, Adult, Double-Blind Method, Female, Humans, Male, Middle Aged, Risk Factors, Social Behavior.
Abstract
Movement disorders in first-episode psychosis are increasingly recognized; however, the prevalence and clinical correlates are uncertain. We compared antipsychotic exposed (< 12 weeks) with nonexposed first-episode patients, and report prevalence as well as clinical and demographic variables associated with extrapyramidal dysfunction. Data are baseline assessments from a multicentre, international drug trial of first-episode psychosis (n = 535). Analysis included the Extrapyramidal Symptom Rating Scale, Premorbid Adjustment Scale, and the Positive and Negative Syndrome Scale. Of non-exposed patients, 28.1% (n = 47/167) had at least one mild sign of extrapyramidal dysfunction, as did 46.3% (n = 169/365) of previously exposed patients. Hypokinetic Parkinsonism was the most prevalent disorder. The severity of movement disorders and negative symptoms were correlated; however, the effect sizes were small. Logistic regression analysis indicated that the salient risk factors for all patients were: previous antipsychotic exposure [odds ratio (OR) = 2.4; 95% confidence interval (CI) 1.6-3.6] and poor premorbid functioning (OR = 1.8; 95% CI 1.2-2.6). For the non-exposed group (n = 167), the significant risk factors were: having severe mental illness in the family (OR = 2.9; 95% CI 1.2-7.2) and poor premorbid functioning (OR = 2.3; 95% CI 1.0-5.3). For the previously exposed group (n = 368), the significant variables were: poor premorbid functioning (OR = 1.8; 95%CI 1.2-2.8) and shorter duration of untreated psychosis (OR = 0.78; 95% CI 0.64-0.94). Although antipsychotic exposure was associated with extrapyramidal signs, the results indicate that many first-episode patients with no exposure to antipsychotics also had extrapyramidal dysfunction. In this group, family history and poor premorbid functioning appear to be associated with increased risk for movement disorders.
DOI: 10.1177/0269881105051539
PubMed: 15888513
Affiliations:
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Honer</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry, University of British Columbia, Vancouver, Canada. honer@interchg.ubc.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Psychiatry, University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Kopala, Lili C" sort="Kopala, Lili C" uniqKey="Kopala L" first="Lili C" last="Kopala">Lili C. Kopala</name></author><author><name sortKey="Rabinowitz, Jonathan" sort="Rabinowitz, Jonathan" uniqKey="Rabinowitz J" first="Jonathan" last="Rabinowitz">Jonathan Rabinowitz</name></author></analytic><series><title level="j">Journal of psychopharmacology (Oxford, England)</title><idno type="ISSN">0269-8811</idno><imprint><date when="2005" type="published">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Akathisia, Drug-Induced (epidemiology)</term><term>Akathisia, Drug-Induced (physiopathology)</term><term>Antipsychotic Agents (adverse effects)</term><term>Antipsychotic Agents (therapeutic use)</term><term>Basal Ganglia Diseases (chemically induced)</term><term>Basal Ganglia Diseases (epidemiology)</term><term>Basal Ganglia Diseases (physiopathology)</term><term>Double-Blind Method</term><term>Female</term><term>Haloperidol (adverse effects)</term><term>Haloperidol (therapeutic use)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (epidemiology)</term><term>Parkinson Disease (physiopathology)</term><term>Psychotic Disorders (complications)</term><term>Psychotic Disorders (drug therapy)</term><term>Risk Factors</term><term>Risperidone (adverse effects)</term><term>Risperidone (therapeutic use)</term><term>Schizophrenia (complications)</term><term>Schizophrenia (drug therapy)</term><term>Social Behavior</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antipsychotic Agents</term><term>Haloperidol</term><term>Risperidone</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Basal Ganglia Diseases</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Psychotic Disorders</term><term>Schizophrenia</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Psychotic Disorders</term><term>Schizophrenia</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Akathisia, Drug-Induced</term><term>Basal Ganglia Diseases</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Akathisia, Drug-Induced</term><term>Basal Ganglia Diseases</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antipsychotic Agents</term><term>Haloperidol</term><term>Risperidone</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Risk Factors</term><term>Social Behavior</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Movement disorders in first-episode psychosis are increasingly recognized; however, the prevalence and clinical correlates are uncertain. We compared antipsychotic exposed (< 12 weeks) with nonexposed first-episode patients, and report prevalence as well as clinical and demographic variables associated with extrapyramidal dysfunction. Data are baseline assessments from a multicentre, international drug trial of first-episode psychosis (n = 535). Analysis included the Extrapyramidal Symptom Rating Scale, Premorbid Adjustment Scale, and the Positive and Negative Syndrome Scale. Of non-exposed patients, 28.1% (n = 47/167) had at least one mild sign of extrapyramidal dysfunction, as did 46.3% (n = 169/365) of previously exposed patients. Hypokinetic Parkinsonism was the most prevalent disorder. The severity of movement disorders and negative symptoms were correlated; however, the effect sizes were small. Logistic regression analysis indicated that the salient risk factors for all patients were: previous antipsychotic exposure [odds ratio (OR) = 2.4; 95% confidence interval (CI) 1.6-3.6] and poor premorbid functioning (OR = 1.8; 95% CI 1.2-2.6). For the non-exposed group (n = 167), the significant risk factors were: having severe mental illness in the family (OR = 2.9; 95% CI 1.2-7.2) and poor premorbid functioning (OR = 2.3; 95% CI 1.0-5.3). For the previously exposed group (n = 368), the significant variables were: poor premorbid functioning (OR = 1.8; 95%CI 1.2-2.8) and shorter duration of untreated psychosis (OR = 0.78; 95% CI 0.64-0.94). Although antipsychotic exposure was associated with extrapyramidal signs, the results indicate that many first-episode patients with no exposure to antipsychotics also had extrapyramidal dysfunction. In this group, family history and poor premorbid functioning appear to be associated with increased risk for movement disorders.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><noCountry><name sortKey="Kopala, Lili C" sort="Kopala, Lili C" uniqKey="Kopala L" first="Lili C" last="Kopala">Lili C. Kopala</name><name sortKey="Rabinowitz, Jonathan" sort="Rabinowitz, Jonathan" uniqKey="Rabinowitz J" first="Jonathan" last="Rabinowitz">Jonathan Rabinowitz</name></noCountry><country name="Canada"><noRegion><name sortKey="Honer, William G" sort="Honer, William G" uniqKey="Honer W" first="William G" last="Honer">William G. Honer</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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