Nonresponding schizophrenia: differentiation by neurological soft signs and neuropsychological tests.

Abstract

Schizophrenia patients have higher scores on neurological soft-signs (NSS) and show greater deficits on a variety of neuropsychological tests than normal control subjects and mixed groups of psychiatric patients. Among chronic schizophrenia patients it is unclear which of these types of deficits most strongly differentiates patients who remain consistently symptomatic in spite of treatment with several conventional neuroleptics (nonresponders) as compared with relapsing chronic schizophrenia patients who improve substantially with treatment (relative responders). In this study, 25 nonresponders and 20 relative responders to conventional neuroleptics were compared on an NSS battery and a limited number of neuropsychological tests, which evaluated deficits influenced by functioning of frontal and nonfrontal brain areas. NSS scores showed the largest difference between relative responders and nonresponders, and statistical analyses suggested that NSS scores were the strongest differentiator between the two groups of chronic schizophrenia patients. Scores differentiating the two groups involved deficits influenced by both frontal and nonfrontal functioning. A predominance of negative symptoms in the current clinical picture was highly correlated with high NSS scores.