Spontaneous parkinsonism in antipsychotic-naive patients with first-episode psychosis

The purpose of this study was to establish rates of spontaneous parkinsonism (SP) among the different types of psychosis. We hypothesized that the rate would be higher among persons with affective symptoms.

We included in the study consecutive patients admitted to a first-episode psychosis intervention program. We recorded sociodemographic data from interviews with patients and caregivers and from medical records. We used the Simpson-Angus Rating Scale at baseline to assess parkinsonism and a diagnosis of SP was established if the Simpson-Angus score was > or = 0.3.

A total of 174 patients were examined; of these, only 4 (2.3%; 2 Chinese women, 1 Chinese man, and 1 Malay man) had SP. There was a significant difference in the rates of SP in patients with affective psychosis and schizoaffective disorder, compared with those with nonaffective psychoses (15.4% vs 1.2%; chi2 = 10.7, P = 0.001). The 2 groups did not differ significantly in age, duration of untreated psychosis, or sex distribution.

The rate of SP in Asian patients with first-episode psychosis was low, and it was significantly higher in those with affective symptoms.