Comparative study of neurological soft signs in schizophrenia with onset in childhood, adolescence and adulthood

OBJECTIVE: To compare neurological soft signs (NSS) in patients of schizophrenia with onset in childhood (COS), adolescence (AdOS) and adulthood (AOS). METHOD: Assessment of NSS in 15 patients of COS and 20 patients each of AdOS and AOS was made using condensed neuropsychiatric examination for NSS. RESULTS: NSS were significantly more frequent in COS (100%) and AdOS (90%) when compared with AOS (55%) patients. COS patients showed significantly higher scores on temporal and frontal lobe NSS, of which differences between the three groups in temporal lobe NSS disappeared on ancova. Parietal lobe dependent NSS were seen in a few COS patients. The NSS were more in those with lesser IQ, lower education and higher Positive and Negative Syndrome Scale scores. CONCLUSION: Findings indicate that earlier onset types may be more strongly associated with a generalized disruption of brain function. Non-suppression of primitive reflexes with cortical maturation in COS point towards disordered neurodevelopment. Preponderance of fronto-temporal and a relative lack of parietal lobe NSS point towards differential lobar involvement. Neurodevelopmental abnormalities leading to NSS also lead to lower IQ and lower educational level.