Schizophrenia Bulletin Advance Access published online on November 5, 2008
Schizophrenia Bulletin, doi:10.1093/schbul/sbn146
Dyskinesia and Parkinsonism in Antipsychotic-Naive Patients With Schizophrenia, First-Degree Relatives and Healthy Controls: A Meta-analysis
2 Psychiatric Center Symfora groep, Amersfoort, The Netherlands
3 Rudolph Magnus Institute of Neuroscience
4 Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
5 Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands
6 Division of Psychological Medicine, Institute of Psychiatry, London, UK
7 BCN Neuroimaging Center
8 University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
1 To whom correspondence should be addressed; c/o. Mrs T. van Polanen, Symfora groep, Medisch centrum, PO Box 3051, 3800 DB Amersfoort, The Netherlands; tel: +31-33-4609568, fax: +31-33-4609557, e-mail: jpf.koning{at}symfora.nl
Background:Several studies have reported the presence of dyskinesia and parkinsonism in antipsychotic-naive patients with schizophrenia as well as in their first-degree relatives. These movement disorders may therefore form an integral part of the illness and its (genetic) liability. Method: A systematic search was conducted in the Medline, EMBASE, and PsychINFO databases to identify studies reporting on dyskinesia and parkinsonism assessed in antipsychotic-naive patients with schizophrenia (n = 213) and controls (n = 242) and separately in nonill first-degree relatives (n = 395) and controls (n = 379). Effect sizes were pooled using random-effect models to calculate odds ratios (ORs) to compare the risk of these movement disorders among patients and healthy relatives each with matched controls. Results: Antipsychotic-naive schizophrenia was found to be strongly associated with dyskinesia (OR: 3.59, 95% confidence interval [CI]: 1.53–8.41) and parkinsonism (OR: 5.32, 95% CI: 1.75–16.23) compared with controls. Dyskinesia and parkinsonism were also significantly more prevalent in healthy first-degree relatives of patients with schizophrenia as compared with healthy controls (OR: 1.38, 95% CI: 1.06–1.81, and OR: 1.37, 95% CI: 1.05–1.79, respectively).Conclusion: The results suggest that movement disorders, and by inference abnormalities in the nigrostriatal pathway, are not only associated with schizophrenia itself but may also be related to the (genetic) risk of developing the disease.
Keywords: spontaneous / movement disorders / vulnerability / family / nonaffective psychosis
Received for publication June 18, 2008. Revision received September 23, 2008. Accepted for publication October 3, 2008.