Neuroleptic-induced extrapyramidal symptoms are accompanied by cognitive dysfunction in schizophrenia

Cognitive impairments in schizophrenics have been found to precede tardive dyskinesia and to co-exist with other motor deficits. However, little is ye t known about the prevalence of cognitive disturbances in patients with neu roleptic-induced parkinsonism. From the literature on idiopathic parkinson, it was inferred that extrapyramidal symptoms (EPS) are accompanied by cogn itive dysfunction. 85 schizophrenic in-patients were divided into EPS high and low scorers according to an established criterion (Simpson Angus Scale, cut-off score: 0.4). Cognitive impairments were assessed using a self-rati ng instrument measuring disturbances of information processing. Patients with high EPS exhibited significantly elevated scores in six of te n cognitive and perceptual subscales (t = 2.1-3.1) as compared to low EPS p atients. It is concluded that high EPS patients suffer from cognitive distu rbances which are assumed to possess high relevance for both psyche-social and medical treatment. Cognitive problems may, when not considered, disturb compliance, insight of illness and transfer of learnt skills into everyday life. (C) 1999 Elsevier, Paris.