Primitive (developmental) reflexes, tardive dyskinesia and intellectual impairment in schizophrenia

Primitive reflexes, also known as higher cerebral, developmental or release reflexes, are present in foetal and infant life, and are found in certain organic brain diseases. They are normally regarded as non-localising signs of cerebral immaturity or dysfunction which are uncommon in the normal population. The main aims of this study were to find out whether recent reports of an association between primitive reflexes and severity of cognitive impairment in dementia and between primitive reflexes and tardive dyskinesia in schizophrenia could be replicated in a younger population of schizophrenic patients. Forty-eight schizophrenic patients (mean age 51 years) were assessed for primitive reflexes, involuntary movements and cognitive function, and 58% exhibited at least one primitive reflex and 23% at least two. No association was found between primitive reflexes and cognitive impairment or between primitive reflexes and tardive dyskinesia. These results fail to support the hypothesis that the presence of primitive reflexes in some schizophrenic patients indicates a vulnerability to tardive dyskinesia and intellectual decline with advancing age, but long-term prospective studies would be required to test this hypothesis adequately. Nevertheless, these findings support the notion of neurodevelopmental or neurodegenerative brain disease in at least a proportion of patients with schizophrenia.