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14-02-2012 | Psychology | Article

Neurologic soft signs increased in teens with first-episode psychosis


Free abstract

MedWire News: Results from a Spanish study show that adolescents with first-episode early-onset psychosis (EOP) exhibit more neurologic soft signs (NSS) than their mentally healthy peers.

"NSS are subtle neurological abnormalities that cannot be related to impairment of a specific brain region and are not part of a neurological syndrome," explain María Mayoral (Hospital General Universitario Gregorio Marañón, Madrid) and team.

They say that a number of previous studies have reported an increase in NSS among adult patients with schizophrenia, but add that few studies have investigated NSS among adolescents with early-onset psychosis, or the progression of NSS during adolescence.

To address this, the researchers studied 110 adolescent patients with first-episode EOP who were aged less than 18 years (mean age 15.5 years) at baseline and 98 mentally healthy adolescents (controls) who were aged a mean of 15.2 years. Of the EOP patients, 53 were diagnosed with schizophrenia, 22 with bipolar disorder, and 35 with other psychoses at the 2-year follow-up.

All of the participants were assessed for NSS at baseline and at follow up using the Neurological Evaluation Scale (NES). This scale consists of 26 items clustered into the four subscales of "sensory integration," "motor coordination," "sequencing of complex motor acts," and "other."

The researchers found that the EOP patients showed significantly more NSS at baseline and follow up compared with controls, with total NES scores of 25.21 versus 11.11, and 19.85 versus 9.17, respectively. There were no significant differences in NES scores at baseline or follow up among the three diagnostic groups of EOP patients.

Interestingly, although NES scores were greater in patients than controls at both time-points, EOP patients showed significantly greater reductions than controls in NES scores for "motor coordination" and "other" over the study period, at 0.76 versus 0.21, and 2.17 versus 0.60, respectively, as well as a greater reduction in total NES scores, the researchers note.

Mayoral and colleagues conclude in the Journal of Child Psychology and Psychiatry: "The present results show that the severity of NSS is greater in child and adolescent patients with first-episode psychosis than in healthy controls during the first psychotic episode and 2 years later."

They add: "Our study supports the role of NSS as an endophenotype not only for schizophrenia but for psychotic disorders in general."

By Mark Cowen

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