Neurological soft signs in first-episode psychosis: a systematic review*

DAZZAN, PAOLA
MURRAY, ROBIN M.

PAOLA DAZZAN, MRCPsych, ROBIN M. MURRAY, FRCPsych, Institute of Psychiatry, London, UK

*Presented in part at the European First Episode Schizophrenia Network Meeting, Whistler BC, Canada, 27 April 2001.

Correspondence: Dr Paola Dazzan, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF. Tel: +44 (0) 207 848 0590; fax: +44 (0) 207 701 9044; e-mail: [email protected]

British Journal of Psychiatry 181:p s50-s57, September 2002.

Background

Neurological soft signs (NSS) are minor neurological signs indicating non-specific cerebral dysfunction. Their presence has been documented extensively in schizophrenia but not during the first psychotic episode.

Aims

To review studies that have specifically investigated NSS at the time of the first psychotic episode.

Method

A review of studies investigating neurological function in first-episode psychosis, using a clinical examination.

Results

Patients with first-episode psychosis show an excess of NSS, particularly in the areas of motor coordination and sequencing, sensory integration and in developmental reflexes. Furthermore, NSS may be associated with a specific laterality pattern.

Conclusions

More studies on first-onset schizophrenia are needed, evaluating both sensory and motor neurological domains (scoring separately for the two sides of the body), integrating this knowledge with neuroimaging findings and clarifying the role of NSS as markers of cognitive dysfunction.

Declaration of interest

None. Funding from the Stanley Foundation and the Medical Research Council (UK).