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Movement Disorder in Never and Minimally Treated Nigerian Schizophrenic Patients

Published online by Cambridge University Press:  02 January 2018

Robin G. McCreadie*
Affiliation:
Crichton Royal Hospital, Dumfries DG1 4TG, Scotland
Jude U. Ohaeri
Affiliation:
Department of Psychiatry, University College Hospital, Ibadan, Nigeria
*
Correspondence

Abstract

Two hundred and forty-two Nigerian schizophrenic patients (63% male, 37% female), whose mean age was 42 years and length of illness 12 years, were examined for movement disorders using the Abnormal Involuntary Movements Scale, the Simpson and Angus Parkinsonism Scale and the Barnes Akathisia Scale. Twelve patients had never received antipsychotic medication; and none of these had dyskinesia. Dyskinesia was found in 5 of 49 patients (10%) who had taken medication throughout the course of their illness for a total of up to 3 months, 13 of 74 (18%) who had taken medication for 4–12 months, 14 of 41 (34%) for 1–5 years, and 29 of 66 (45%) who had taken medication for more than 5 years. Of 77 patients who were receiving antipsychotic medication at the time of examination, 9 (12%) had Parkinsonism and 12 (15%) akathisia. Examination of the patients' mental state by the Positive and Negative Syndrome Scale showed an association between dyskinesia and positive, but not negative, schizophrenic symptoms. Nigerian patients showed a low level of negative symptoms.

Type
Papers
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
American Psychiatric Association Task Force (1980) Tardive dyskinesia: summary. American Journal of Psychiatry, 137, 11631172.Google Scholar
Barnes, T. R. E. (1989) A rating scale for drug induced akathisia. British Journal of Psychiatry, 154, 672676.10.1192/bjp.154.5.672CrossRefGoogle ScholarPubMed
Bartzokis, G., Hill, M. A., Altshuler, L., et al (1989) Tardive dyskinesia in schizophrenic patients: correlation with negative symptoms. Psychiatry Research, 28, 145151.10.1016/0165-1781(89)90042-5CrossRefGoogle ScholarPubMed
Bourgeois, M., Bouilh, P., Tignol, J., et al (1980) Spontaneous dyskinesias vs neuroleptic-induced dyskinesias in 270 elderly subjects. Journal of Nervous and Mental Disease, 168, 177178.10.1097/00005053-198003000-00009CrossRefGoogle ScholarPubMed
Brown, K. W. & White, T. (1992) The influence of topography on the cognitive and psychopathological effects of tardive dyskinesia. American Journal of Psychiatry, 149, 13851389.Google ScholarPubMed
Chorfi, M. & Moussaoui, D. (1985) Les schizophrenes jamais traites n'ont pas de movements anormaux type dyskinesie tardive. L'Encephale, 11, 263265.Google ScholarPubMed
Davis, J. M. (1985) Antipsychotic drugs. In Comprehensive Textbook of Psychiatry (eds H. I. Kaplan & B. J. Sadock). Baltimore: Williams and Wilkins.Google Scholar
Delwaide, P. J. & Desseilles, M. (1977) Spontaneous buccolinguofacial dyskinesia in the elderly. Acta Neurologica Scandinavica, 56, 256262.10.1111/j.1600-0404.1977.tb01431.xCrossRefGoogle ScholarPubMed
Gold, J. M., Egan, M. F., Kirch, D. G., et al (1991) Tardive dyskinesia: neuropsychological, computerized tomographic, and psychiatric symptom findings. Biological Psychiatry, 30, 587599.10.1016/0006-3223(91)90028-KCrossRefGoogle ScholarPubMed
Goldman, M. B. & Luchins, D. J. (1984) Intermittent neuroleptic therapy and tardive dyskinesia: a literature review. Hospital and Community Psychiatry, 35, 12151219.Google ScholarPubMed
Gureje, O. (1989) Correlates of positive and negative schizophrenic syndromes in Nigerian patients. British Journal of Psychiatry, 155, 628632.10.1192/S0007125000018110CrossRefGoogle ScholarPubMed
Iager, A. C., Kirch, D. G., Jeste, D. V., et al (1986) Defect symptoms and abnormal involuntary movement in schizophrenia. Biological Psychiatry, 21, 751755.10.1016/0006-3223(86)90240-4CrossRefGoogle ScholarPubMed
Jegede, R. O. (1981) A study of the role of socio-cultural factors in the treatment of mental illness in Nigeria. Social Science and Medicine, 15A, 4954.Google Scholar
Kane, J. M., Woerner, M., Weinhold, P., et al (1983) Epidemiology of tardive dyskinesia. Clinical Neuropharmacology, 6, 109115.10.1097/00002826-198306000-00005CrossRefGoogle ScholarPubMed
Kane, J. M., Woerner, M., & Liberman, J. (1988) Tardive dyskinesia: prevalence, incidence and risk factors. Journal of Clinical Pharmacology, 8 (suppl. 4), 52S56S.Google ScholarPubMed
Katz, M., Marsella, A., Dube, K. C., et al (1988) On the expression of psychosis in different cultures: schizophrenia in an Indian and in a Nigerian community. Culture, Medicine and Psychiatry, 12, 331355.10.1007/BF00051973CrossRefGoogle Scholar
Kay, S. R., Fiszbein, S. & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 262273.10.1093/schbul/13.2.261CrossRefGoogle ScholarPubMed
Kraepelin, E. (1919) Dementia Praecox and Paraphrenia (translated by R. M. Barclay). Edinburgh: E. & S. Livingstone.Google Scholar
Lewis, S. (1992) Sex and schizophrenia: vive la difference. British Journal of Psychiatry, 161, 445450.10.1192/bjp.161.4.445CrossRefGoogle ScholarPubMed
McCreadie, R. G., Barron, E. T. & Winslow, G. S. (1982) The Nithsdale Schizophrenia Survey. II. Abnormal movements. British Journal of Psychiatry, 140, 587590.10.1192/bjp.140.6.587CrossRefGoogle ScholarPubMed
McCreadie, R. G., Robertson, L. J. & Wiles, D. H. (1992a) The Nithsdale Schizophrenia Surveys. IX. Akathisia, Parkinsonism, tardive dyskinesia and plasma neuroleptic levels. British Journal of Psychiatry, 161, 793799.10.1192/bjp.160.6.793CrossRefGoogle Scholar
McCreadie, R. G., Hall, D. J., Berry, I., et al (1992b) The Nithsdale Schizophrenia Surveys. X. Obstetric complications, family history and abnormal movements. British Journal of Psychiatry, 161, 799805.10.1192/bjp.160.6.799CrossRefGoogle Scholar
Odejide, A. O. & Ohaeri, J. U. (1990) The existing psychiatric care facilities in the nation. In Strategies for Integrating Mental Health into the National Primary Health Care Scheme (eds Makanjuola, J. D., Odejide, A. O. & Erinosho, A. O.). Lagos: Federal Ministry of Health.Google Scholar
Ohaeri, J. U. (1992) Age at onset in a cohort of schizophrenics in Nigeria. Acta Psychiatrica Scandinavica, 86, 332334.10.1111/j.1600-0447.1992.tb03275.xCrossRefGoogle Scholar
Ohaeri, J. U. (1993) Long term outcome of treated schizophrenia in a Nigerian cohort: retrospective analysis of 7-year follow-ups. Journal of Nervous and Mental Disease, 181, 514516.10.1097/00005053-199308000-00007CrossRefGoogle Scholar
Owens, D. G. C. & Johnstone, E. C. (1980) The disabilities of chronic schizophrenia: their nature and factors contributing to their development. British Journal of Psychiatry, 136, 384395.10.1192/bjp.136.4.384CrossRefGoogle Scholar
Owens, D. G. C. & Johnstone, E. C. (1982) Spontaneous involuntary disorders of movement. Archives of General Psychiatry, 39, 452461.10.1001/archpsyc.1982.04290040052008CrossRefGoogle ScholarPubMed
Prosser, E. S., Csernansky, J. G., Kaplan, J., et al (1987) Depression, Parkinsonian symptoms, and negative symptoms in schizophrenics treated with neuroleptics. Journal of Nervous and Mental Disease, 175, 100105.10.1097/00005053-198702000-00006CrossRefGoogle ScholarPubMed
Sartorius, N., Jablensky, A., Korten, A., et al (1986) Early manifestations and first contact incidence of schizophrenia in different cultures. Psychological Medicine, 16, 909928.10.1017/S0033291700011910CrossRefGoogle ScholarPubMed
Schooler, N. R. & Kane, J. M. (1982) Research diagnoses for tardive dyskinesia. Archives of General Psychiatry, 39, 486487.Google ScholarPubMed
Simpson, G. M. & Angus, J. W. S. (1970) A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica, suppl. 212, 1119.CrossRefGoogle Scholar
US Department of Health, Education and Welfare (1976) Abnormal involuntary movements scale (AIMS). In ECDEU Assessment Manual (ed. W. Guy), pp 534537. Rockville, MD: US Department of Health, Education and Welfare.Google Scholar
Varga, E., Sugerman, A. A., Varga, V., et al (1982) Prevalence of spontaneous oral dyskinesia in the elderly. American Journal of Psychiatry, 139, 329331.Google ScholarPubMed
Waddington, J. L., Youssef, H. A., Dolphin, C., et al (1987) Cognitive dysfunction, negative symptoms, and tardive dyskinesia in schizophrenia. Archives of General Psychiatry, 44, 907912.10.1001/archpsyc.1987.01800220077011CrossRefGoogle ScholarPubMed
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