Diagnosis and treatment of motor phenomena in schizophrenia spectrum disorders

Motor abnormalities are intrinsic features of schizophrenia spectrum disorders. They may be spontaneous or antipsychotic drug-induced. The four most important symptom groups are abnormal involuntary movements or dyskinesia, Parkinsonism, catatonia and neurological soft signs. In addition, there are further motor abnormalities, which are less frequent and less operationalized. The suspected etiology of motor abnormalities is strongly associated with altered neurodevelopment. Delayed maturation in conjunction with environmental insults may give further rise to motor symptoms. For the four most relevant motor abnormalities clinical examination procedures and rating scales are available, aiding clinicians in both screening and evaluation of symptom severity. Besides these currently instrumental measures are being tested for wide spread and easy application. Treatment of motor abnormalities is necessary according to subjective well-being. Treatment options are few and remain symptomatic. The most important strategy is critical evaluation of antispychotic pharmacotherapy. Benefitial effects on motor phenomena have been noted with clozapine. Currently, specific substances against tardive dyskinesia and non-invasive brain stimulation techniques are being evaluated. However, the effeciacy of these approaches will only be available in the near future.