Abnormal Voluntary Movements

Although voluntary movement disorders have not been as extensively studied as involuntary movement disorders, data do exist, such as those generated by Manschreck et al. (1982) in their investigation of abnormal voluntary movements in schizophrenic subjects and mood-disordered patient control subjects. The assessment included a 1-hour examination of spontaneous motor activity, examination of simple and complex motor tasks, and evaluation of medication side effects. The findings indicated that 36 of 37 schizophrenic subjects showed disturbed voluntary movements, whereas mood-disordered subjects showed less frequent and less severe disturbances. These were voluntary motor disturbances and not associated with evidence of medication effects. Indeed, antipsychotic medication had a marginally positive impact in reducing the occurrence of such movements, which did not resemble the forms of disturbance characteris tic of drug-induced motor effects. These voluntary disturbances fell into three general categories: disruption in the smoothness and coordination of movements, intermittent repetitive movements (e.g., stereotypies), and disturbances in performing sequential actions. These abnormalities were frequent but seldom dramatic in their presentation, and could easily be missed without careful examination. Certain unusual catatonic behaviors, for example, were not observed; on the other hand, stereotyped and manner-istic behaviors were common. These results have been replicated (Heinrichs and Buchanan 1988; Manschreck and Ames 1984) and demonstrate the presence of intrinsic voluntary motor abnormality in schizophrenia.

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