TY - JOUR
T1 - Neurological Signs at the First Psychotic Episode as Correlates of Long-Term Outcome
T2 - Results From the AESOP-10 Study
AU - Ferruccio, Naika P.
AU - Tosato, Sarah
AU - Lappin, Julia M.
AU - Heslin, Margaret
AU - Donoghue, Kim
AU - Giordano, Annalisa
AU - Lomas, Ben
AU - Reininghaus, Ulrich
AU - Onyejiaka, Adanna
AU - Chan, Raymond C. K.
AU - Croudace, Tim
AU - Jones, Peter B.
AU - Murray, Robin M.
AU - Fearon, Paul
AU - Doody, Gillian A.
AU - Morgan, Craig
AU - Dazzan, Paola
N1 - Funding Information:
This work was supported by the UK Medical Research Council (ref: G0500817) and the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London.
Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.
PY - 2021/1
Y1 - 2021/1
N2 - Minor neurological signs are subtle deficits in sensory integration, motor coordination, and sequencing of complex motor acts present in excess in the early stages of psychosis. Still, it remains unclear whether at least some of these signs represent trait or state markers for psychosis and whether they are markers of long-term disease outcome of clinical utility. We examined the relationship between neurological function at illness onset assessed with the Neurological Evaluation Scale and subsequent illness course in 233 patients from AESOP-10 (Aetiology and Ethnicity in Schizophrenia and Other Psychoses), a 10-year follow-up study of a population-based cohort of individuals recruited at the time of their first episode of psychosis in the United Kingdom. In 56 of these patients, we also explored changes in neurological function over time. We included a group of 172 individuals without psychosis as controls. After 10 years, 147 (63%) patients had developed a non-remitting course of illness, and 86 (37%) a remitting course. Already at first presentation, patients who developed a non-remitting course had significantly more primary, motor coordination, and total signs than both remitting patients and healthy controls. While Motor Coordination signs did not change over time, rates of Primary, Sensory Integration, and Total signs increased, independently of illness course type. These findings suggest that motor coordination problems could be a useful early, quick, and easily detectable marker of subsequent clinical outcome. With other motor abnormalities, a measure of motor incoordination could contribute to the identification of the most vulnerable individuals, who could benefit from targeted and more assertive treatment approaches.
AB - Minor neurological signs are subtle deficits in sensory integration, motor coordination, and sequencing of complex motor acts present in excess in the early stages of psychosis. Still, it remains unclear whether at least some of these signs represent trait or state markers for psychosis and whether they are markers of long-term disease outcome of clinical utility. We examined the relationship between neurological function at illness onset assessed with the Neurological Evaluation Scale and subsequent illness course in 233 patients from AESOP-10 (Aetiology and Ethnicity in Schizophrenia and Other Psychoses), a 10-year follow-up study of a population-based cohort of individuals recruited at the time of their first episode of psychosis in the United Kingdom. In 56 of these patients, we also explored changes in neurological function over time. We included a group of 172 individuals without psychosis as controls. After 10 years, 147 (63%) patients had developed a non-remitting course of illness, and 86 (37%) a remitting course. Already at first presentation, patients who developed a non-remitting course had significantly more primary, motor coordination, and total signs than both remitting patients and healthy controls. While Motor Coordination signs did not change over time, rates of Primary, Sensory Integration, and Total signs increased, independently of illness course type. These findings suggest that motor coordination problems could be a useful early, quick, and easily detectable marker of subsequent clinical outcome. With other motor abnormalities, a measure of motor incoordination could contribute to the identification of the most vulnerable individuals, who could benefit from targeted and more assertive treatment approaches.
KW - clinical outcome
KW - first-episode psychosis
KW - neurological signs
KW - remission
UR - http://www.scopus.com/inward/record.url?scp=85089963685&partnerID=8YFLogxK
U2 - 10.1093/schbul/sbaa089
DO - 10.1093/schbul/sbaa089
M3 - Article
C2 - 32656567
SN - 0586-7614
VL - 47
SP - 118
EP - 127
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 1
ER -