M55. Neurological Soft Signs (NSS) and Psychopathology in Chronic Schizophrenia Through the Lifespan

摘要

>Background: Minor motor and sensory deficits or neurological soft signs (NSS) have frequently been described in patients with schizophrenia at any stage of their illness. However, patients with chronic schizophrenia and a duration of illness of several decades were rather scarcely investigated. Previous results (1) of our group demonstrated a significant age-effect, indicating increasing NSS with higher age, which was more pronounced in patients with chronic schizophrenia than age-matched healthy controls. >Methods: To examine potential associations between NSS and psychopathology (including apathy) we investigated 90 patients with chronic schizophrenia from 3 age groups (18–29, 30–49, + 50 years of age). NSS were assessed using the Heidelberg Scale, psychopathology was rated on the SAPS/SANS, BPRS and AES (2) scales, respectively. >Results: While negative symptoms (SANS, BPRS-anergia) and apathy (AES) differed not significantly between age groups, BPRS “thought disturbance” and “hostility/suspiciousness” were significantly elevated in the youngest patient group. NSS total scores and the subscales “motor coordination” and “complex motor tasks” were significantly correlated with duration of illness, while controlling for age. Moreover, NSS scores correlated significantly with positive symptoms (SAPS), BPRS “thought disturbance” and apathy (AES). These results were confirmed after age/duration of illness and years of education were partialled out. >Conclusion: Our results underline the hypothesis that NSS are associated with chronicity of the disorder as indicated by the correlations between NSS and duration of illness and apathy, which is defined as a much broader concept than negative symptoms are. The correlations between NSS and SAPS/BPRS “thought disturbance” correspond to the fluctuation of positive symptoms during the course of the disorder. This interpretation is indirectly facilitated by the clinical observation of a decline of positive symptoms with aging.1. Herold, C.J., Lässer, M.M., Seidl, U., Hirjak, D., Thomann, P.A., Schröder, J.(submitted). Neurological soft signs and psychopathology in chronic schizophrenia: A cross-sectional study in 3 age groups.2. Lueken, U., Seidl, U., Schwarz, M., Völker, L., Naumann, D., Mattes, K., Schröder, J., Schweiger, E. (2006). [Psychometric properties of a German version of the Apathy Evaluation Scale]. Fortschr. Neurol. Psychiatr. 74(12), 714–722.