Abstract
Schizophrenia is frequently associated with abnormal motor behavior, particularly hypokinesia. The course of the illness tends to deteriorate in the first years. We aimed to assess gross motor activity in patients with a first episode (n = 33) and multiple episodes (n = 115) of schizophrenia spectrum disorders using wrist actigraphy. First episode patients were younger, had higher motor activity and reduced negative symptom severity. Covarying for age, chlorpromazine equivalents, and negative symptoms, first episode patients still had higher motor activity. This was also true after excluding patients with schizophreniform disorder from the analyses. In first episode patients, but not in patients with multiple episodes, motor activity was correlated with antipsychotic dosage. In conclusion, after controlling for variables related to disorder chronicity, patients with first episodes were still more active than patients with multiple episodes. Thus, reduced motor activity is a marker of deterioration in the course of schizophrenia spectrum disorders.
Highlights
The first episode is of particular interest to schizophrenia research because it allows assessing the clinical presentation in the absence of factors related to illness chronicity
The current study aimed to test whether physical activity as measured by wrist actigraphy would differ between first episode and multiple episode patients with schizophrenia spectrum disorders
The difference in activity level (AL) between groups remained when all subjects with schizophreniform disorder were excluded from the ANCOVA (F = 4.2, df = 4, p = 0.003, η2 = 0.13) with the positive and negative syndrome scale (PANSS) negative syndrome subscale score, age, and Chlorpromazine equivalents (CPZ) as covariates
Summary
The first episode is of particular interest to schizophrenia research because it allows assessing the clinical presentation in the absence of factors related to illness chronicity. Objective measures acquired with actigraphy have established hypokinesia in schizophrenia, which is correlated with negative symptom severity [8,9,10]. Objectively assessed gross motor activity has not been tested in first episode patients. Even though 67% of unmedicated first episode patients present with at least one motor sign [11], first episode patients tend to present with less or comparably severe negative symptoms as patients with multiple episodes [12, 13]. The current study aimed to test whether physical activity as measured by wrist actigraphy would differ between first episode and multiple episode patients with schizophrenia spectrum disorders. We hypothesized that physical activity was higher in first episode patients compared to multiple episode patients, as functional decline often occurs within the early course of the disorder [1]
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