Vulnerability to involuntary movements over a lifetime trajectory of schizophrenia approaches 100%, in association with executive (frontal) dysfunction

This study assessed the prevalence of involuntary movements among older inp atients with severe schizophrenia, many of whom had experienced a lifetime of illness and its treatment, and examined their neuropsychological correla tes. The subjects of this study were 128 inpatients with a DSM-IV diagnosis of schizophrenia. They were assessed using the Abnormal Involuntary Moveme nt Scale, the Mini-Mental State Examination for general cognitive impairmen t and the Executive Interview for executive dyscontrol; additionally, their medical records were reviewed in detail for treatment histories. Prevalenc e of involuntary movements was examined and their clinical correlates deter mined in relation to topography of movement disorder using logistic regress ion. In schizophrenia, prevalence of involuntary movements was: age < 65 ye ars, 63%; 65-75 years. 80%; > 75 years, 93%. The primary correlate both of overall and of orofacial movements was poor executive function, whereas the primary correlate of limb-trunkal movements was poor general cognitive fun ction. On approaching the limits of human longevity following a lifetime tr ajectory of illness and its treatment, essentially 'all' patients with schi zophrenia appear inherently vulnerable to the emergence of involuntary move ments in topographically specific association with cognitive deficits. (C) 2001 Elsevier Science B.V, All rights reserved.