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Parakinesia: A Delphi consensus report.

Schizophr Res

January 2024

Klinik für Psychiatrie & Psychotherapie, Städtisches Klinikum Dresden, Dresden, Germany.

Abnormal movements are intrinsic to some forms of endogenous psychoses. Spontaneous dyskinesias are observed in drug-naïve first-episode patients and at-risk subjects. However, recent descriptions of spontaneous dyskinesias may actually represent the rediscovery of a more complex phenomenon, 'parakinesia' which was described and documented in extensive cinematographic recordings and long-term observations by German and French neuropsychiatrists decades before the introduction of antipsychotics.

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Background: Major changes in the treatment of schizophrenia have taken place in recent years, including a shift from inpatient to community care, and the introduction of second-generation antipsychotics and psychosocial interventions. Recent evidence has questioned the superiority of these interventions over older treatments.

Aims: We wished to ascertain the impact of changes in the treatment of schizophrenia in a geographically-defined area, focusing on clinical symptoms and psychosocial outcome.

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Edentulous orodyskinesia (ED) is a neglected source of aimless oral movements that may be confused with tardive dyskinesia (TD). We attempted to clarify the clinical features, significance, and orodental factors in relation to ED. Fourteen ED subjects, 13 TD patients, and 15 age-matched controls self-assessed their oral pain perception, condition, and function using a visual analogue scale.

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Cognitive impairments in schizophrenics have been found to precede tardive dyskinesia and to co-exist with other motor deficits. However, little is yet known about the prevalence of cognitive disturbances in patients with neuroleptic-induced parkinsonism. From the literature on idiopathic parkinson, it was inferred that extrapyramidal symptoms (EPS) are accompanied by cognitive dysfunction.

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