Methods of assessment of spontaneous and drug-induced motor disorders in schizophrenia
Olga Kałużyńska, Jolanta Rabe-Jabłońska

It has been known for a long time that at least some motor abnormalities are observed in neuroleptic-naive patients with schizophrenia more frequently than in the general population. Introduction of antipsychotic drugs hampered investigations of spontaneous motor disorders, because attention of researchers was focused only on the motor disorders induced by neuroleptic treatment. Several studies have also shown that certain motor disorders are more common and more severe in the first-degree relatives of patients with schizophrenia, but less frequent and less severe than in the affected subjects. Today, there are many tools – clinical scales based on clinical observation to evaluate the incidence and severity of motor disorders, both spontaneous and associated with antipsychotic treatment. They are used both in practice and in scientific studies. Usually by means of these scales the symptoms of parkinsonism, dystonia and akathisia are assessed and monitored. It is believed that all of these tools have several shortcomings and do not enable to detect and measure subclinical or mild motor abnormalities. Instrumental methods of assessment of spontaneous motor disorders and dysfunctions induced by neuroleptics are more sensitive and therefore useful in the search for subtle disorders. Thus, they can be used in identification of individuals with the so-called “atrisk state”, assessment of motor dysfunctions in relatives of schizophrenic patients and finally, evaluation of response to the neuroleptic treatment. Most of these methods require sophisticated equipment and established procedure of analysis of the results. Multifaceted assessment of the handwriting is also an interesting and relatively simple instrumental tool. These new methods of assessment of motor disorders would be also useful in the studies on the selected motor disorders in terms of their suitability as an endophenotype of schizophrenia.