Neurological soft signs in first episode psychosis among psychiatric hospital patients and its relationship with dimensions of psychopathology: A comparative study.

Journal: The Nigerian postgraduate medical journal

Volume: 30

Issue: 3

Year of Publication: 2023

Affiliated Institutions:  Department of Mental Health, Nnamdi Azikiwe University Teaching Hospital, Nnewi Campus, Anambra State, Nigeria. Department of Psychological Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria. Department of Mental Health, College of Medicine, University of Maiduguri, Borno State, Nigeria. Department of Clinical Services, Federal Neuropsychiatric Hospital, Sokoto, Nigeria. Department of Mental Health, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria.

Abstract summary 

Neurological soft signs (NSS), as subtle, nonlocalising neurological abnormalities, are considered as the potential markers of psychosis. However, comparative studies of antipsychotic-naïve patients with first-episode psychosis (FEP) and first degree relatives (FDRs) are uncommon. We compared the prevalence and pattern of NSS in FEPs, their healthy FDRs and a healthy non-relatives' control group (HC), highlighted the relationship between NSS and psychopathology and proposed cut-off scores for prevalence studies.Two hundred and two participants per group were recruited. The FEPs were consecutive attendees; FDRs were accompanying caregivers; while the HC were from hospital staff. The Brief Psychiatric Rating Scale and the Neurological Evaluation Scale were used to assess psychopathology dimensions and NSS, respectively.Using an item score of two ('substantial impairment'), the prevalence of at least one NSS was: 91.5% (95% confidence interval [CI]: 86.7%-94.9%), 16.8% (95% CI: 11.8%-22.7%) and 6.5% (95% CI: 3.5%-10.9%), respectively, for FEP, FDRs and HC. FEPs were impaired in a broad range of signs. The noteworthy relationships were as follows: (i) a significant correlation between the negative symptoms' dimension versus number of NSS (r = 0.4), and NSS total score (r = 0.3), (ii) the anxiety/depression dimension correlated negatively with number of NSS (r = -0.3) and (iii) NSS cut across psychosis categories. We propose a cut-off score of ≥ 4 for the number of signs signifying probable impairment.The findings indicate that, subject to further studies, NSS could be regarded as a broader phenotype of neurologic dysfunction associated with psychosis proness.

Authors & Co-authors:  Nwiyi Obumneme Kenechukwu OK Ohaeri Jude Uzoma JU Jidda Mohammed Said MS Danjuma Ishiak Abioda IA Onu Justus Uchenna JU Oriji Sunday Onyemaechi SO Uwakwe Richard R

Study Outcome 

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Citations : 
Authors :  7
Identifiers
Doi : 10.4103/npmj.npmj_77_23
SSN : 1117-1936
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Comparative study;dimensions of psychopathology;first-episode psychosis;neurological soft signs
Study Design
Study Approach
Country of Study
Mali
Publication Country
Nigeria