Skip to main content

Abnormal Movements in Never-Medicated Indian Patients with Schizophrenia

  • R. G. McCreadie (a1), R. Thara (a2), S. Kamath (a2), R. Padmavathy (a2), S. Latha (a2), N. Mathrubootham (a3) and M. S. Menon (a2)...

Historical records suggest dyskinesia was observed in severely ill institutionalised patients with schizophrenia in the pre-neuroleptic era More recent work has not found dyskinesia in never-medicated younger and middle aged patients. The present study complements this recent work and avoids the confounders of severity of illness and institutionalism by examining elderly patients in a wide variety of community settings.


Movement disorders were examined in 308 elderly individuals in Madras, India, using the Abnormal Involuntary Movements Scale, the Simpson and Angus Parkinsonism Scale and the Barnes Akathisia Scale. Patients' mental state was assessed by the Positive and Negative Syndrome Scale.


Dyskinesia was found in 15% of normal subjects (n=101, mean age 63 years), 15% of first degree blood relatives of younger schizophrenic patients (n=103, mean age 63 years), 38% of never medicated patients (n=21, mean age 65 years) and 41 % of medicated patients (n=83, mean age 57 years). The respective prevalences for Parkinsonism were 6%, 11 %, 24% and 36%; and for akathisia 9%, 5%, 21 % and 23%. Dyskinesia was associated with negative schizophrenic symptoms.


Dyskinesia in elderly schizophrenic patients is an integral part of the illness and not associated with antipsychotic medication.

Corresponding author
R. G. McCreadie, Director of Clinical Research, Crichton Royal Hospital, Dumfries, DG1 4TG
Hide All
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Barnes, T. R. E. (1989) A rating scale for drug-induced akathisia. British Journal of Psychiatry, 154, 672676.
Bourgeois, M., Bouilh, P., Tignol, J., et al (1980) Spontaneous dyskinesias v. neuroleptic-induced dyskinesias in 270 elderly subjects. Journal of Nervous and Mental Disease, 168, 177178.
Caugiuri, M. P., Lohr, J. B. & Jeste, D. V. (1993) Parkinsonism in neuroleptic-naive schizophrenic patients. American Journal of Psychiatry, 150, 13431348.
Casey, D. E. & Hansen, T. E. (1984) Spontaneous dyskinesias. In Neuropsychiatric Movement Disorders (eds Jeste, D. V. & Wyatt, R. J.). Washington, DC: American Psychiatric Press.
Chorfi, M. & Moussaoui, D. (1985) Les schizophrenics jamais traites n'ont pas de movements anormaux type dyskinesia tardive. L'Encéphale, 11, 263265.
Davis, K. L., Kahn, R. S., Ko, G., et al (1991) Dopamine in schizophrenia: a review and reconceptualization. American Journal of Psychiatry, 148, 14741486.
Fenton, W. S., Wyatt, R. J. & McGlashan, T. H. (1994) Risk factors for spontaneous dyskinesia in schizophrenia. Archives of General Psychiatry, 51, 643650.
Kay, S. R., Fiszbein, S. & Opler, L. A. (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 262273.
Kraepelin, E. (1919) Dementia Praecox and Paraphrenia (translated by Barclay, R. M.). Edinburgh: E & S Livingstone.
McCreadie, R. G. & Ohaeri, J. U. (1994) Movement disorder in never and minimally treated Nigerian schizophrenic patients. British Journal of Psychiatry, 164, 184189.
Morgensen, P. B. & Juel, K. (1990) Mortality and causes of death in schizophrenic patients in Denmark. Acta Psychiatrica Scandinavica, 81, 372377.
Owens, D. G. C., Johnstone, E. C. & Frith, C. D. (1982) Spontaneous involuntary disorders of movement. Archives of General Psychiatry, 39, 452461.
Schooler, N. R. & Kane, J. M. (1982) Research diagnoses for tardive dyskinesia. Archives of General Psychiatry, 39, 486487.
Simpson, G. M. & Angus, J. W. S. (1970) A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica, suppl. 212, 1119.
Turner, T. (1989) Rich and mad in Victorian England. Psychological Medicine, 19, 2944.
US Department of Health, Education and Welfare (1976) Abnormal Involuntary Movements Scale (AIMS). In ECDEU Assessment Manual (ed. Guy, W.), pp. 534537. Rockville, MD: US Department of Health, Education and Welfare.
Varga, E., Sugerman, A. A., Varga, V., et al (1982) Prevalence of spontaneous oral dyskinesia in the elderly. American Journal of Psychiatry, 139, 329331.
Waddington, J. L. (1995) Psychopathological and cognitive correlates of tardive dyskinesia in schizophrenic and other disorders treated with neuroleptic drugs. In Behavioural Neurology of Movement Disorders (eds Weiner, W. J. & Lang, A. E.). Advances in Neurology, vol. 65. New York: Raven Press.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 10 *
Loading metrics...

Abstract views

Total abstract views: 61 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 25th May 2018. This data will be updated every 24 hours.

Abnormal Movements in Never-Medicated Indian Patients with Schizophrenia

  • R. G. McCreadie (a1), R. Thara (a2), S. Kamath (a2), R. Padmavathy (a2), S. Latha (a2), N. Mathrubootham (a3) and M. S. Menon (a2)...
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *