BACKGROUND The aim of this systematic review and meta-analysis is to evaluate and compare the prevalence rates of spontaneous movement disorders (SMDs), including dyskinesia, parkinsonism, akathisia and dystonia, in antipsychotic-naïve individuals with chronic psychosis and first-episode psychosis (FEP) and gain a more nuanced understanding of factors influencing their presence. METHODS Several literature databases were systematically searched and screened based on predetermined eligibility criteria. Included articles underwent risk of bias assessment. The prevalence rates of SMDs were calculated using a random-effects model. RESULTS Out of 711 articles screened, 27 were included in this meta-analysis. The pooled prevalence of spontaneous dyskinesia was 7% (3% FEP and 17% chronic schizophrenia) across 24 studies (95% CI 3 to 11; I2=94%, p<0.01) and 15% for spontaneous parkinsonism (14% FEP and 19% chronic schizophrenia) in 21 studies (95% CI 12 to 20; I2=81%, p<0.01). A meta-regression analysis found a significant positive correlation between age (p<0.05) and duration of untreated psychosis (DUP) (p<0.05) with dyskinesia but not parkinsonism prevalence. Akathisia and dystonia appear to be both less studied and less frequent in occurrence with a pooled prevalence of 4% (95% CI: 3 to 6; I2=0%, p=0.65) for akathisia in eight studies and a mean prevalence of 6% (range 0%-16%) for dystonia in five studies. CONCLUSION The presence of varying degrees of neurodysfunction in antipsychotic-naïve patients with schizophrenia underscores the need for individualised treatment approaches that consider each patient's unique predisposition and neuromotor profile. Further research is warranted into the role of specific SMDs and risk factors including sex, race and diagnostic variations. PROSPERO REGISTRATION NUMBER CRD42024501951.

中文翻译：

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未经治疗的慢性和首发精神病患者自发运动障碍（运动障碍、帕金森症、静坐不能和肌张力障碍）的患病率：系统评价和荟萃分析。


背景 本系统评价和荟萃分析的目的是评估和比较患有慢性精神病和首发精神病的未接受抗精神病药物治疗的个体中自发运动障碍（SMD）的患病率，包括运动障碍、帕金森症、静坐不能和肌张力障碍。 FEP）并更细致地了解影响其存在的因素。方法 根据预定的资格标准系统地检索和筛选多个文献数据库。纳入的文章接受了偏倚风险评估。使用随机效应模型计算 SMD 的患病率。结果 在筛选的 711 篇文章中，有 27 篇纳入本荟萃分析。 24 项研究中，自发性运动障碍的汇总患病率为 7%（3% FEP 和 17% 慢性精神分裂症）（95% CI 3 至 11；I2=94%，p<0.01），自发性帕金森病的患病率为 15%（14% FEP 和 19% 慢性精神分裂症）在 21 项研究中（95% CI 12 至 20；I2=81%，p<0.01）。荟萃回归分析发现，年龄 (p<0.05) 和未经治疗的精神病 (DUP) 持续时间 (p<0.05) 与运动障碍呈显着正相关，但与帕金森病患病率无关。静坐不能和肌张力障碍似乎研究较少，发生频率也较低，八项研究中静坐不能的汇总患病率为 4%（95% CI：3 至 6；I2=0%，p=0.65），平均患病率为 6五项研究中肌张力障碍的百分比（范围 0%-16%）。结论 未接受抗精神病药物治疗的精神分裂症患者存在不同程度的神经功能障碍，这强调了需要考虑每位患者独特的倾向和神经运动特征的个体化治疗方法。 需要进一步研究特定 SMD 的作用和风险因素，包括性别、种族和诊断变异。普洛斯彼罗注册号 CRD42024501951。