Neurological Signs at the First Psychotic Episode as Correlates of Long-Term Outcome: Results From the AESOP-10 Study

Ferruccio, Naika P; Tosato, Sarah; Lappin, Julia M; Heslin, Margaret; Donoghue, Kim; Giordano, Annalisa; Lomas, Ben; Reininghaus, Ulrich; Onyejiaka, Adanna; Chan, Raymond C K; Croudace, Tim; Jones, Peter B; Murray, Robin M; Fearon, Paul; Doody, Gillian A; Morgan, Craig; Dazzan, Paola

Abstract

Minor neurological signs are subtle deficits in sensory integration, motor coordination, and sequencing of complex motor acts present in excess in the early stages of psychosis. Still, it remains unclear whether at least some of these signs represent trait or state markers for psychosis and whether they are markers of long-term disease outcome of clinical utility. We examined the relationship between neurological function at illness onset assessed with the Neurological Evaluation Scale and subsequent illness course in 233 patients from AESOP-10 (Aetiology and Ethnicity in Schizophrenia and Other Psychoses), a 10-year follow-up study of a population-based cohort of individuals recruited at the time of their first episode of psychosis in the United Kingdom. In 56 of these patients, we also explored changes in neurological function over time. We included a group of 172 individuals without psychosis as controls. After 10 years, 147 (63%) patients had developed a non-remitting course of illness, and 86 (37%) a remitting course. Already at first presentation, patients who developed a non-remitting course had significantly more primary, motor coordination, and total signs than both remitting patients and healthy controls. While Motor Coordination signs did not change over time, rates of Primary, Sensory Integration, and Total signs increased, independently of illness course type. These findings suggest that motor coordination problems could be a useful early, quick, and easily detectable marker of subsequent clinical outcome. With other motor abnormalities, a measure of motor incoordination could contribute to the identification of the most vulnerable individuals, who could benefit from targeted and more assertive treatment approaches.

• Journal Article Type: Article
• Acceptance Date: Jun 13, 2020
• Online Publication Date: Jul 13, 2020
• Publication Date: 2021-01
• Deposit Date: Jul 2, 2020
• Publicly Available Date: Jul 14, 2021
• Journal: Schizophrenia Bulletin
• Print ISSN: 0586-7614
• Electronic ISSN: 1745-1701
• Publisher: Oxford University Press (OUP)
• Peer Reviewed: Peer Reviewed
• Volume: 47
• Issue: 1
• Pages: 118–127
• DOI: https://doi.org/10.1093/schbul/sbaa089
• Keywords: Psychiatry and Mental health
• Public URL: https://nottingham-repository.worktribe.com/output/4744839
• Publisher URL: https://academic.oup.com/schizophreniabulletin/article/doi/10.1093/schbul/sbaa089/5870569
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Schizophrenia Bulletin following peer review. The version of record Naika P Ferruccio, Sarah Tosato, Julia M Lappin, Margaret Heslin, Kim Donoghue, Annalisa Giordano, Ben Lomas, Ulrich Reininghaus, Adanna Onyejiaka, Raymond C K Chan, Tim Croudace, Peter B Jones, Robin M Murray, Paul Fearon, Gillian A Doody, Craig Morgan, Paola Dazzan, Neurological Signs at the First Psychotic Episode as Correlates of Long-Term Outcome: Results From the AESOP-10 Study, Schizophrenia Bulletin, , sbaa089 is available online at: https://doi.org/10.1093/schbul/sbaa089.