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The British Journal of Psychiatry (2002) 181: 135-137
© 2002 The Royal College of Psychiatrists

Spontaneous dyskinesia and parkinsonism in never-medicated, chronically ill patients with schizophrenia: 18-month follow-up

R. G. McCREADIE, DSc

Crichton Royal Hospital, Dumfries, UK

R. PADMAVATI, MD, R. THARA, MD and T. N. SRINIVASAN, MD

Schizophrenia Research Foundation (India), Chennai, India

Correspondence: Professor R.G. McCreadie, Crichton Royal Hospital, Dumfries DGI 4TG, UK. Tel: 01387 244000; fax 01387 257735; e-mail: rgmccreadie_crh{at}compuserve.com

Declaration of interest None.

Background Spontaneous dyskinesia and parkinsonism have been reported in never-medicated patients with schizophrenia but there has been no previous study of the natural history of these conditions.

Aims To determine the prevalence of spontaneous dyskinesia and parkinsonism in a group of never-medicated, chronically ill patients with schizophrenia on two occasions separated by an 18-month interval.

Method Dyskinesia was assessed by the Abnormal Involuntary Movements Scale using Schooler and Kane criteria for its presence; parkinsonism by the Simpson and Angus scale; and mental state by the Positive and Negative Syndrome Scale for schizophrenia.

Results Thirty-seven patients were examined on two occasions. Nine (24%) had dyskinesia on both occasions, 12 (33%) on one occasion and 16 (43%) on neither occasion. Twenty-one (57%) had dyskinesia on at least one occasion. Thirteen patients (35%) had parkinsonism on at least one occasion.

Conclusions Spontaneous dyskinesia and parkinsonism fluctuate over time. The former was found on at least one occasion in the majority of patients. It is an integral part of the schizophrenic disease process.


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