First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment

	First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment
	Honer, William G.1; Lang, Donna J.2; Kopala, Lili C.1,3; Macewan, G. William 1; Smith, Geoffrey N.1; Chen, Eric Y. H.4; Chan, Raymond C. K.5 ; Honer, WG (reprint author), Univ British Columbia, Dept Psychiat, Vancouver, BC, Canada.
摘要	Extrapyramidal movement disorders are common in chronic schizophrenia, and may be an intrinsic feature of the illness as well as related to antipsychotic drug treatment. Similar dysfunctions at illness onset may have implications for outcome, and for understanding the mechanisms of illness. The objectives were to examine the clinical correlates of pre-treatment movement disorders at first episode of psychosis, and determine associations with neuropsychological function and striatal structure. Never medicated subjects were recruited from consecutive admissions to Early Psychosis Programs with defined catchment areas in Hong Kong, China, and Halifax, Canada. Standardized clinical, neuropsychological and brain imaging assessments were carried out at baseline and following acute and long term treatment with typical or atypical antipsychotic drugs. At the Hong Kong site, we studied 84 subjects with first episode psychosis (n = 10 with EPS). At the Halifax site, we studied 40 subjects with first episode psychosis (n = 17 with EPS), and 23 healthy comparison subjects. Subjects with movement disorders prior to treatment (EPS+) had higher total PANSS scores at baseline (mean elevation 19.9% Hong Kong, P = 0.016; 14.7% Halifax, P = 0.049). In subjects treated with atypical antipsychotics (all Halifax), EPS+ status at baseline predicted more movement disorders at long term follow up (P = 0.0005). In both cohorts, EPS+ subjects had poorer acute symptomatic treatment response assessed with the PANSS (Hong Kong P = 0.005; Halifax P = 0.017). Neuropsychological impairment related to executive dysfunction appeared greater in a small sample of EPS+ subjects (Hong Kong, effect size 0.26-0.27, P < 0.05). Caudate volumes were 4.5% larger in EPS+ compared with EPS-subjects (Halifax P = 0.042), and correlations between striatal volumes and age were different in the EPS+ group. In conclusion, pre-treatment EPS is present in a substantial minority of subjects with first episode psychosis, appears to persist at long term follow up, and is associated with poorer response of symptoms to treatment. Selective impairment of executive function and striatal enlargement provides evidence of abnormalities of brain function and structure associated with this aspect of early psychosis.
关键词	schizophrenia movement disorder basal ganglia antipsychotics cognitive psychosis
学科领域	Abnormal Psychology
	2011-11-01
语种	英语
发表期刊	CHINESE SCIENCE BULLETIN
ISSN	1001-6538
卷号	56 期号:32 页码:3361-3371
期刊论文类型	Article
URL	查看原文
收录类别	SCI
项目简介	This work was supported by the Canadian Institutes of Health Research (NET-54013), the Michael Smith Foundation for Health Research and investigator-initiated grants from Janssen-Ortho of Canada and Eli Lilly Canada. Additional funding for scanning was provided by the Queen Elizabeth-II Hospital Health Science Research Foundation and the Department of Psychiatry, Dalhousie University. Dr. Kopala was supported by a Clinical Scientist Award from Dalhousie University.
WOS记录号	WOS:000296641800002
资助机构	Canadian Institutes of Health Research [NET-54013] ; Michael Smith Foundation for Health Research ; Janssen-Ortho of Canada ; Eli Lilly Canada ; Queen Elizabeth-II Hospital Health Science Research Foundation ; Department of Psychiatry, Dalhousie University ; Dalhousie University
引用统计	被引频次：2[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	http://ir.psych.ac.cn/handle/311026/11527
专题	中国科学院心理健康重点实验室
通讯作者	Honer, WG (reprint author), Univ British Columbia, Dept Psychiat, Vancouver, BC, Canada.
作者单位	1.Univ British Columbia, Dept Psychiat, Vancouver, BC, Canada 2.Univ British Columbia, Dept Radiol, Vancouver, BC, Canada 3.Dalhousie Univ, Dept Psychiat, Halifax, NS, Canada 4.Univ Hong Kong, Dept Psychiat, Hong Kong, Hong Kong, Peoples R China 5.Chinese Acad Sci, Inst Psychol, Key Lab Mental Hlth, Beijing 100101, Peoples R China
推荐引用方式 GB/T 7714	Honer, William G.,Lang, Donna J.,Kopala, Lili C.,et al. First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment[J]. CHINESE SCIENCE BULLETIN,2011,56(32):3361-3371.
APA	Honer, William G..,Lang, Donna J..,Kopala, Lili C..,Macewan, G. William.,Smith, Geoffrey N..,...&Honer, WG .(2011).First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment.CHINESE SCIENCE BULLETIN,56(32),3361-3371.
MLA	Honer, William G.,et al."First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment".CHINESE SCIENCE BULLETIN 56.32(2011):3361-3371.

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