Vulnerability to involuntary movements over a lifetime trajectory of schizophrenia approaches 100%, in association with executive (frontal) dysfunction

• Published in: Schizophrenia research 2001-04, Vol.49 (1), p.79-87
• Main Authors: Quinn, John, Meagher, David, Murphy, Patrice, Kinsella, Anthony, Mullaney, James, Waddington, John L.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Antipsychotic Agents - administration & dosage; Antipsychotic Agents - adverse effects; Biological and medical sciences; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognition Disorders - physiopathology; Cognitive dysfunction; Dyskinesia, Drug-Induced - diagnosis; Dyskinesia, Drug-Induced - etiology; Executive dyscontrol; Female; Frontal Lobe - physiopathology; Humans; Involuntary movements; Male; Medical sciences; Middle Aged; Neuropsychological Tests; Psychology. Psychoanalysis. Psychiatry; Psychomotor Disorders - diagnosis; Psychomotor Disorders - etiology; Psychopathology. Psychiatry; Psychoses; Schizophrenia; Schizophrenia - complications; Schizophrenia - drug therapy; Schizophrenia - physiopathology; Severity of Illness Index; Tardive dyskinesia
• ISSN: 0920-9964; 1573-2509
• DOI: 10.1016/S0920-9964(99)00220-0

This study assessed the prevalence of involuntary movements among older inpatients with severe schizophrenia, many of whom had experienced a lifetime of illness and its treatment, and examined their neuropsychological correlates. The subjects of this study were 128 inpatients with a DSM-IV diagnosis of schizophrenia. They were assessed using the Abnormal Involuntary Movement Scale, the Mini-Mental State Examination for general cognitive impairment and the Executive Interview for executive dyscontrol; additionally, their medical records were reviewed in detail for treatment histories. Prevalence of involuntary movements was examined and their clinical correlates determined in relation to topography of movement disorder using logistic regression. In schizophrenia, prevalence of involuntary movements was: age 75 years, 93%. The primary correlate both of overall and of orofacial movements was poor executive function, whereas the primary correlate of limb-trunkal movements was poor general cognitive function. On approaching the limits of human longevity following a lifetime trajectory of illness and its treatment, essentially ‘all’ patients with schizophrenia appear inherently vulnerable to the emergence of involuntary movements in topographically specific association with cognitive deficits.