Biomedical subjects

Tirupati N Srinivasan

Publications and source records attributed to Tirupati N Srinivasan.

4 recordsLinked to original sources

PubMed2005

Extrapyramidal symptoms in unmedicated schizophrenia.

Studies of spontaneous extrapyramidal symptoms, dyskinesia and parkinsonism, in unmedicated schizophrenia are of importance in understanding their underlying pathology and relation to the psychosis. This is a study of extrapyramidal symptoms using Abnormal Involuntary Movements Scale for dyskinesia and Simpson-Angus Scale for parkinsonism in 143 schizophrenia patients who never received antipsychotic medication. Psychopathology was measured using the Positive and Negative Syndrome Scale. Dyskinesia was present in 35% of patients and parkinsonism in 15%. The two disorders coexisted in 11 subjects. Orofacial dyskinesia, rigidity and tremor were common symptoms noted. There was no significant change in the rates and total scores of dyskinesia and parkinsonism with gender, age, duration of illness or age at onset of psychosis. Dyskinesia was unrelated to psychopathology. Parkinsonism score correlated positively with the motor symptom cluster of psychopathology. Dyskinesia and parkinsonism scores correlated positively with each other and parkinsonism score discriminated presence of dyskinesia. The associations between the spontaneous abnormal movements and other aspects of schizophrenia differed from those described in treated patients. Dyskinesia and parkinsonism are an integral part of the schizophrenia disease process whose relationship with other factors could be influenced by antipsychotic drug treatment.

Adult↗

PubMed2003

Spontaneous dyskinesia in first-degree relatives of chronically ill, never-treated people with schizophrenia.

BACKGROUND: We have suggested recently that there may be a subgroup of schizophrenia, namely schizophrenia with dyskinesia and striatal pathology. Might movement disorders be more common in relatives of those with schizophrenia and dyskinesia than in relatives of those without dyskinesia? Aims To determine the prevalence of abnormal movements in first-degree relatives of people with schizophrenia who themselves do or do not have abnormal movements. METHOD: Chronically ill, never-treated people with schizophrenia in south India (n=70) and their first-degree relatives (n=181) were examined for dyskinesia using the Abnormal Involuntary Movements Scale (AIMS) and for parkinsonism by the Simpson and Angus scale. RESULTS: Of all relatives, 25 (14%) had dyskinetic movements in at least one body area and 6 (3%) had parkinsonism. Siblings of people with schizophrenia and dyskinesia, compared with siblings of people without dyskinesia, had a higher total AIMS score and more had mild dyskinetic movements in at least one area (5/15 v. 3/34, P=0.04). There were no between-group differences in parkinsonism. CONCLUSIONS: Dyskinesia but not parkinsonism is more common in siblings of people with schizophrenia who have the corresponding movement disorder.

Adult↗

PubMed2002

Structural brain differences between never-treated patients with schizophrenia, with and without dyskinesia, and normal control subjects: a magnetic resonance imaging study.

BACKGROUND: In south India, abnormal movements indistinguishable from tardive dyskinesia have been observed in chronically ill patients with schizophrenia who have never received antipsychotic medication. The present study, using magnetic resonance imaging, examines brain structure in such patients, in those without dyskinesia, and in normal control subjects. METHODS: Chronically ill patients with schizophrenia with and without dyskinesia and controls were identified in villages south of Chennai, India (each group, n = 31). Patients' mental state was assessed by the Positive and Negative Syndrome Scale for schizophrenia, dyskinesia by the Abnormal Involuntary Movements Scale, and parkinsonism by the Simpson and Angus scale. In patients and controls, magnetic resonance imaging measured the volume of the caudate and lentiform nuclei and the lateral ventricle-hemisphere ratio. RESULTS: The left lentiform nucleus was significantly (11%) larger in patients with dyskinesia compared with controls, and the right lateral ventricle-hemisphere ratio was significantly (33%) larger in patients without dyskinesia compared with controls. In all 3 groups, there were significant positive correlations between age and ventricle-hemisphere ratio. In controls, but not in patients, there were significant negative correlations between age and the volume of the caudate and lentiform nuclei. CONCLUSIONS: Never-treated patients with dyskinesia may have striatal pathologic conditions and may represent a subgroup of patients with schizophrenia; in those without abnormal movements, cortical atrophy is more apparent. The schizophrenic process may interfere with normal age-related anatomical changes in the basal ganglia.

Adolescent↗

PubMed2002

At issue: management of medication noncompliance in schizophrenia by families in India.

Noncompliance with medication during a symptomatic phase is a common problem in the treatment of schizophrenia patients. In India, a majority of patients live with their families and those families supervise patients' medication intake. In a study of patients attending an urban outpatient care center in India, it was noted that when the patients were acutely ill and refused to take medication, the families administered medication to them without patients' knowledge, under the supervision of the psychiatrist. This method had been practiced by families in half the cases of patient noncompliance. Many families felt that there was no other viable alternative under the circumstances. Only a minority of patients was aware of having received medication through this method, and many of them reacted negatively to it. However, the patients were subsequently taking treatment voluntarily following the reduction in the severity of the behavioral disorder with the involuntary treatment. The issues involved in this form of treatment are discussed with regard to the social and health care environment in the country.

Adult↗