This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Wayne S. Fenton, MD; Richard Jed Wyatt, MD; Thomas H. McGlashan, MD

Arch Gen Psychiatry. 1994;51(8):643-650.

Abstract
Objective
We describe the prevalence, clinical correlates, and prognostic significance of spontaneous dyskinesias among 100 patients with schizophrenia from the Chestnut Lodge Follow-up Study who had never received treatment with neuroleptic agents up to and including the baseline assessment.

Design
Extensive case records were screened and descriptions of abnormal movements were recorded verbatim for blind rating. Neuroleptic-naive patients with and without abnormal oral-facial movements were compared across sign and symptom, schizophrenia subtype, and illness natural history variables.

Results
Excluding three patients with motor symptoms who had a history of neurologic illness or injury and three who had received prochlorperazine maleate therapy (Compazine), 23% of patient records documented some form of movement disorder; 15% documented oral-facial dyskinesias with sufficient detail so that their presence was considered nearly certain. Compared with patients with schizophrenia without oral-facial movements, patients with oral-facial dyskinesias were more likely to demonstrate a lower IQ score, had more negative symptoms at index admission, and were more symptomatic at follow-up an average of 23 years later. Both the classic hebephrenic schizophrenia subtype and Carpenter's Criteria for the Deficit Syndrome defined high-risk groups for spontaneous oralfacial dyskinesia.

Conclusions
In previous studies, intellectual impairment and negative symptoms have been described as risk factors for neuroleptic-induced tardive dyskinesia. The present data, however, suggest that in many cases oralfacial dyskinesias in patients with intellectual impairment and negative symptoms may actually represent spontaneous movement disorders associated with hebephrenic or deficit forms of schizophrenia.

Author Affiliations
From the Chestnut Lodge Research Institute, Rockville, Md (Dr Fenton); the Department of Psychiatry and Behavioral Science, George Washington University School of Medicine, Washington, DC (Dr Fenton); the Neuropsychiatry Branch, National Institute of Mental Health Neuroscience Center at St Elizabeth's, Washington, DC (Dr Wyatt); and the Yale Psychiatric Institute, New Haven, Conn (Dr McGlashan).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Neurological Signs and Involuntary Movements in Schizophrenia: Intrinsic To and Informative on Systems Pathobiology
Whitty et al.
Schizophr Bull 2009;35:415-424.
ABSTRACT | FULL TEXT  

Dysfunctional Neural Plasticity in Patients With Schizophrenia
Daskalakis et al.
Arch Gen Psychiatry 2008;65:378-385.
ABSTRACT | FULL TEXT  

Wayne Fenton's Impact on Academic Neuroscience
Geyer and Tamminga
Schizophr Bull 2007;33:1156-1159.
ABSTRACT | FULL TEXT  

Identifying Unmet Therapeutic Domains in Schizophrenia Patients: The Early Contributions of Wayne Fenton From Chestnut Lodge
McGlashan and Carpenter
Schizophr Bull 2007;33:1086-1092.
ABSTRACT | FULL TEXT  

Extrapyramidal symptoms and signs in first-episode, antipsychotic exposed and non-exposed patients with schizophrenia or related psychotic illness
Honer et al.
J Psychopharmacol 2005;19:277-285.
ABSTRACT  

MIND AND MOVEMENT: THE NEUROPSYCHIATRY OF MOVEMENT DISORDERS
Lennox and Lennox
J. Neurol. Neurosurg. Psychiatry 2002;72:i28-31.
FULL TEXT  

A Separate Disease Within the Syndrome of Schizophrenia
Kirkpatrick et al.
Arch Gen Psychiatry 2001;58:165-171.
ABSTRACT | FULL TEXT  

Assessment of drug-related movement disorders in schizophrenia
Gervin and Barnes
Adv. Psychiatr. Treat. 2000;6:332-341.
FULL TEXT  

Volumetric Measure of the Frontal and Temporal Lobe Regions in Schizophrenia: Relationship to Negative Symptoms
Sanfilipo et al.
Arch Gen Psychiatry 2000;57:471-480.
ABSTRACT | FULL TEXT  

Neurological Signs and the Heterogeneity of Schizophrenia
Arango et al.
Am. J. Psychiatry 2000;157:560-565.
ABSTRACT | FULL TEXT  

Spontaneous dyskinesia in first episode schizophrenia
Puri et al.
J. Neurol. Neurosurg. Psychiatry 1999;66:76-78.
ABSTRACT | FULL TEXT  

Spontaneous Abnormal Involuntary Movements in First-Episode Schizophrenia and Schizophreniform Disorder: Baseline Rate in a Group of Patients From an Irish Catchment Area
Gervin et al.
Am. J. Psychiatry 1998;155:1202-1206.
ABSTRACT | FULL TEXT  

Summer Birth and the Deficit Syndrome of Schizophrenia
Kirkpatrick et al.
Am. J. Psychiatry 1998;155:1221-1226.
ABSTRACT | FULL TEXT  

Spontaneous Dyskinesia in Subjects With Schizophrenia Spectrum Personality
Cassady et al.
Am. J. Psychiatry 1998;155:70-75.
ABSTRACT | FULL TEXT  

Characterization of Psychotic Conditions: Use of the Domains of Psychopathology Model
Ratakonda et al.
Arch Gen Psychiatry 1998;55:75-81.
ABSTRACT | FULL TEXT  

Rhesus Incompatibility as a Risk Factor for Schizophrenia in Male Adults
Hollister et al.
Arch Gen Psychiatry 1996;53:19-24.
ABSTRACT  

Risks of Withdrawing Antipsychotic Medications
Wyatt
Arch Gen Psychiatry 1995;52:205-208.
ABSTRACT