The British Journal of Psychiatry (2008) 193: 197-202. doi: 10.1192/bjp.bp.107.045450
© 2008 The Royal College of Psychiatrists
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Neurological abnormalities and cognitive ability in first-episode psychosis

Paola Dazzan, MRCPsych

Institute of Psychiatry, King’s College London

Tuhina Lloyd, MRCPsych

Division of Psychiatry, University of Nottingham

Kevin D. Morgan, PhD, Jolanta Zanelli, MSc, Craig Morgan, PhD, Ken Orr, FRANZCPsych, Gerard Hutchinson, MRCPsych, Paul Fearon, MRCPsych, Matthew Allin, MRCPsych, Larry Rifkin, MRCPsych and Philip K. McGuire, MRCPsych

Institute of Psychiatry, King’s College London

Gillian A. Doody, MPhil MRCPsych

Division of Psychiatry, University of Nottingham

John Holloway, MRCPsych

Division of Psychiatry, University of Bristol

Julian Leff, FRCPsych

Institute of Psychiatry, King’s College London

Glynn Harrison, FRCPsych

Division of Psychiatry, University of Bristol

Peter B. Jones, FRCPsych

Division of Psychiatry, University of Cambridge

Robin M. Murray, FRCPsych

Institute of Psychiatry, King’s College London, UK

Correspondence: Paola Dazzan, Department of Psychiatry, Box 63, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: p.dazzan{at}iop.kcl.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

It remains unclear if the excess of neurological soft signs, or of certain types of neurological soft signs, is common to all psychoses, and whether this excess is simply an epiphenomenon of the lower general cognitive ability present in psychosis.

Aims

To investigate whether an excess of neurological soft signs is independent of diagnosis (schizophrenia v. affective psychosis) and cognitive ability (IQ).

Method

Evaluation of types of neurological soft signs in a prospective cohort of all individuals presenting with psychoses over 2 years (n=310), and in a control group from the general population (n=239).

Results

Primary (P<0.001), motor coordination (P<0.001), and motor sequencing (P<0.001) sign scores were significantly higher in people with any psychosis than in the control group. However, only primary and motor coordination scores remained higher when individuals with psychosis and controls were matched for premorbid and current IQ.

Conclusions

Higher rates of primary and motor coordination signs are not associated with lower cognitive ability, and are specific to the presence of psychosis.


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M. M. Picchioni and P. Dazzan
Clinical significance of neurological abnormalities in psychosis
Adv. Psychiatr. Treat., November 1, 2009; 15(6): 419 - 427.
[Abstract] [Full Text] [PDF]