Jennifer Sangeetha, S (2016) A Comparative Study of Minor Physical Anomalies and Soft Neurological Signs in Patients with Schizophrenia and General Population. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION : Schizophrenia is perhaps the most dramatic and tragic manifestation of mental illness known to mankind. An understanding of schizophrenia as a human brain disease did not develop until 19th century. Schizophrenia is conceptualized in today’s classification system as a highly complex disorder caused by varied composition of both genetic and environmental factors. The clinical syndrome represents the participation of different multiple pathogenetic pathways. AIM AND OBJECTIVES : AIM : To assess the presence of minor physical anomalies (MPA) and soft neurological signs (SNS ) in patients with schizophrenia and to compare them with general population. OBJECTIVES : 1. To assess the frequency and topographical pattern of minor physical anomalies (MPA) in schizophrenia. 2. To explore the possible relation between severity of schizophrenia and presence of soft neurological signs. 3. To identify the association of minor physical anomalies with the severity of schizophrenia. 4. To compare the presence of minor physical anomalies in patients with schizophrenia and with general population. 5. To observe any difference in soft neurological signs in schizophrenics against the general population. MATERIALS AND METHODS : CASE GROUP : Patients who attended psychiatry OPD diagnosed as schizophrenia as per ICD 10 diagnostic criteria were recruited for study on basis of inclusion criteria. STATISTICAL ANALYSES : Statistical analysis will be done using computerized software (SPSS-20). Descriptive statistics like frequencies, percentages, means and standard deviations will be computed. Parametric and non-parametric analysis will be used appropriately depending on the data collected. Inclusion Criteria : 1. Cases and controls were selected in the age group between 15 and 45 years (both males and females). 2. Persons who meet ICD 10 criteria for schizophrenia were chosen as cases. 3. Persons accompanying patients attending medical OPD were chosen as controls. 4. Patients who were selected as cases were both first episode drug naive and patients who were on drugs. 5. Cases and controls who are willing to participate in the study and who have consented to the study. Exclusion Criteria : 1. Cases and controls with current or past medical or neurological illness. 2. Patients having mental retardation, dementia and substance dependence. 3. Participants who are ill, exhibits aggressiveness and violent behaviour. 4. Cases and controls who are not willing to participate in the study. CONCLUSION : Minor physical anomalies and soft neurological signs were widely prevalent in schizophrenic population. These minor physical anomalies represents fossilized imprints of early embroyonic development Regarding the topographical distribution of these minor physical anomalies, there is an increased distribution of minor physical anomalies in head and in mouth region compared to the periphery. The increased mouth anomaly has been showed already by Stefan et al. which strengthens the neurodevelopmental etiology. The increased occurrence of soft neurological signs in schizophrenic patients also points towards the developmental etiology. More neurological signs in drug naive patients proves the cerebral insult as its etiology and it also shows that these signs were not been related to the side effects of neuroleptic medications. The relationship between soft neurological signs and psychopathology has been influenced by the phase of illness, antipsychotic drugs effects. Minor physical anomalies develop due to altered physical development which reflects early brain insults. Along with the altered early cerebral insults, the environmental insults during the early stage acts as a triggering event for the development of schizophrenia. Correlating the minor physical anomalies with their siblings may expand our knowledge about the developmental cause for the disease. The study in the area of positive and negative symptoms in relation to the presence of minor physical anomalies and the soft neurological signs should be explored further to elucidate better in early prediction of the course and the severity of illness .Our study illustrates the importance of family history in schizophrenic patients to prove the genetic cause and this is better studied if the cases were compared to their siblings which has been studied earlier. Also our study highlights the importance of MPA and SNS as endophenotypes in identifying the schizophrenic illness. The study in finding the association of the MPA and SNS in relation to delusion and hallucination will help in understanding the symptom dimension and etiopathogenesis of the disease process. In our study though the association between PANSS and SNS were not significant, on evaluating individual symptoms like delusion/ Hallucination with that of SNS were found to be significant (<0.05). There is a need for further study with large sample size for better understanding of the association of these signs with the symptomatology and to the severity of illness and treatment response. This will help in identifying high risk individual and possible interventions may be initiated early to prevent the disease occurrence.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Minor Physical Anomalies, Soft Neurological Signs, Schizophrenia, General Population, Comparative Study. |
| Subjects: | MEDICAL > Psychiatry |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Jan 2018 02:20 |
| Last Modified: | 10 Jan 2018 02:20 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5431 |
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