Schizophrenic Psychoses with Motor-Dominant Symptoms: Considerations for a System-Specific Approach

Lang, F U; Dreyhaupt, J; Walther, Sebastian; Becker, T; Jäger, M (2015). Schizophrenic Psychoses with Motor-Dominant Symptoms: Considerations for a System-Specific Approach. Fortschritte der Neurologie, Psychiatrie, 83(8), pp. 437-445. Thieme 10.1055/s-0035-1553430

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In order to reduce heterogeneity in schizophrenia, a system-specific approach consisting of the domains "language", "affect" and "motor behavior" has been proposed. We examined this system-specific approach for its applicability to clinical practice in the motor behavior domain, using the methodological approach of case studies, and discuss here the differences to the positive/negative concept. We analyzed eight cases with stable motor-dominant symptoms, and also quantitatively assessed motor behavior by using the Bern Psychopathology Scale (BPS), a standardized psychopathological assessment instrument, as well as actigraphic data. Characterization of cases using the positive/negative approach was not helpful. We found an overlap of the motor behavior domain with the other two domains. This complicates the application of the system-specific approach in the sense of a typology. Furthermore, we found both relapsing courses with full remission and chronic courses with deterioration within the motor-dominant subtype. Nevertheless, the system-specific approach has heuristic utility for the future.

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