Fine motor performance before and after treatment in schizophrenic and schizoaffective patients

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Twenty-three hospitalized patients with schizophrenia or schizoaffective disorder were tested for fine motor performance by the Crawford Small Parts Dexterity Test (CSP) and a measure of finger tapping (FT) after a 1-week medication-free period. In an attempt to evaluate potential impairment of fine motor performance, these patients were retested after 1 month's treatment with antipsychotic medication. Thirty-eight control subjects were tested and retested after 1 month by the same procedures. On medication, patients showed no decrement of performance on either test. A small practice effect was observed in both patients and control subjects between initial and second testing. Unmedicated patients had significantly lower CSP and FT scores than control subjects. On repeated testing, medicated patients also had significantly lower scores than control subjects. In the patient group, CSP and FT scores during medication were not related to dosage of medication, use of antiparkinsonian agents, or ratings of motor side effects. CSP and FT scores were significantly and inversely correlated with Brief Psychiatric Rating Scale (BPRS) subscale ratings of withdrawal- retardation (R-subscale). FT performance was positively correlated with the schizophrenia (S-subscale) of the BPRS. Global improvement, as measured by change in BPRS total score, was significantly related to improvement in CSP scores. Impairment in fine motor performance after 1 month's treatment with antipsychotic agents could not be documented. The impairment in fine motor performance in drug-free patients may be in part related to deficits of attention and cooperation. However, other deficits in motor performance have been reported in schizophrenic patients. Failure to identify fine motor impairment produced by psychotropic drugs may be related to competing effects of improved attention and motor impairment of extrapyramidal effects.