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Am J Psychiatry 1995; 152:191-196
Copyright © 1995 by American Psychiatric Association
Neurological soft signs in neuroleptic-naive and neuroleptic-treated schizophrenic patients and in normal comparison subjects
S Gupta, NC Andreasen, S Arndt, M Flaum, SK Schultz, WC Hubbard and M Smith
Department of Psychiatry, University of Iowa College of Medicine, Iowa City.
OBJECTIVE: The goal of this study was to assess neurological soft signs and
developmental reflexes in schizophrenic patients who had never received
neuroleptic medication and those who were receiving neuroleptic medication.
METHOD: Neurological soft signs and developmental reflexes were examined in
26 schizophrenic patients who had never received a neuroleptic, 126
schizophrenic patients who were currently receiving neuroleptics, and 117
normal subjects. RESULTS: Soft signs were present in 23% of the
neuroleptic-naive and 46% of the medicated schizophrenic patients.
Developmental reflexes were present in 19% of the neuroleptic-naive and 12%
of the medicated patients. Both soft signs and developmental reflexes were
absent in the normal subjects. There were significant differences between
patients and normal subjects in neurological soft signs and developmental
reflexes. The possibly confounding variables of age, age at onset, duration
of illness, number of hospitalizations, Abnormal Involuntary Movement Scale
(AIMS) scores, and Simpson-Angus Scale extrapyramidal symptom scores were
assessed by using logistic regression in the patients who were receiving
neuroleptics. AIMS scores and Simpson-Angus Scale scores correlated with
soft signs in these patients. CONCLUSIONS: The presence of neurological
soft signs in schizophrenic patients who had never received neuroleptics
indicates that these signs are present independent of medication effects,
but it is possible that neuroleptics contribute to the prevalence of these
abnormalities, as demonstrated by the patients who were receiving
neuroleptics.
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