A comparative study of first episode of schizophrenia and first episode of bipolar disorder (mania) patients on measures of neurological soft sign

Abstract

Background: There is a higher prevalence of Neurological Soft Sign(NSS) in first-episode patients compared with healthy controls. In particular, significantly higher total rates of NSS in patients with first-episode schizophrenia or schizophreniform disorder have been reported. NSS abnormalities have also been reported in other neuropsychiatric disorders, like Schizophreniform disorder and psychosis within the affective spectrum, especially bipolar disorders. However, among the limited studies specifically comparing the NSS abnormalities between Schizophrenia and other neuropsychiatric disorders, the findings had been inconsistent with reference to the specificity of NSS in Schizophrenia.Method:A cross sectional hospital based Analytic type of Observational study was carried out between September 2016 and August 2017 on patients of first episode of Schizophrenia and Bipolar Disorder (mania) attending at psychiatric center, department of psychiatry, SMS medical college & hospital, Jaipur. Study included cases of first episode of Schizophrenia and Bipolar Disorder (mania) [diagnosed as per ICD-10 criteria] satisfying inclusion criteria and exclusion (via screening Performa) and healthy controls.Results: Thetotal NSS score and four components - Primitive reflexes, motor coordination, sensory integration, and response inhibition were significantly higher in the schizophrenia patients compared to the bipolar patients and controls (P<.001). First Episode Schizophrenia (FES) and First Episode Bipolar Disorder (FEBP) patients were significantly impaired in the performance of NSS items compared to healthy controls, but there are no statistical differences between FES and FEBP groups.Conclusion:Present study results concluded that FES and FEBP patients had significantly more NSS on all items compared to the healthy controls. A poorer neurocognitive performance was found amongst FES and FEBP patients as compared to the healthy controls in all the cognitive domains.