Supplementary Material for: Gesture Performance in First- and Multiple-Episode Patients with Schizophrenia Spectrum Disorders

Background/Aim: Gesturing plays an important role in social behavior and social learning. Deficits are frequent in schizophrenia and may contribute to impaired social functioning. Information about deficits during the course of the disease and presence of severity and patterns of impairment in first-episode patients is missing. Hence, we aimed to investigate gesturing in first- compared to multiple-episode schizophrenia patients and healthy controls. Methods: In 14 first-episode patients, 14 multiple-episode patients and 16 healthy controls matched for age, gender and education, gesturing was assessed by the comprehensive Test of Upper Limb Apraxia. Performance in two domains of gesturing - imitation and pantomime - was recorded on video. Raters of gesture performance were blinded. Results: Patients with multiple episodes had severe gestural deficits. For almost all gesture categories, performance was worse in multiple- than in first-episode patients. First-episode patients demonstrated subtle deficits with a comparable pattern. Conclusions: Subjects with multiple psychotic episodes have severe deficits in gesturing, while only mild impairments were found in first-episode patients independent of age, gender, education and negative symptoms. The results indicate that gesturing is impaired at the onset of disease and likely to further deteriorate during its course.研究背景与目的：手势在社会行为与社会学习中发挥重要作用。精神分裂症患者常出现手势功能缺损，该缺损可能进一步损害其社会功能。目前关于精神分裂症患者病程中手势缺损的变化情况，以及首发患者的缺损严重程度与损伤模式的相关信息仍存在空白。因此，本研究旨在对比首发精神分裂症患者、多次发作精神分裂症患者与年龄、性别、受教育程度匹配的健康对照者的手势表现。 研究方法：本研究纳入14名首发精神分裂症患者、14名多次发作精神分裂症患者，以及16名在年龄、性别与受教育程度上匹配的健康对照者。采用上肢失用综合测试（comprehensive Test of Upper Limb Apraxia）对受试者的手势功能进行评估。手势表现的两大维度——模仿与演示性手势（pantomime）的完成情况通过录像进行录制，并由盲法评分者进行评估。 研究结果：多次发作精神分裂症患者存在严重的手势功能缺损。相较于首发患者，多次发作患者在几乎所有手势类别中的表现均更差。首发患者同样表现出细微的手势缺损，且缺损模式与多次发作患者相似。 研究结论：多次发作精神分裂症患者存在严重的手势功能缺损，而首发患者仅表现出轻度损伤，且该损伤不受年龄、性别、受教育程度与阴性症状（negative symptoms）的影响。本研究结果表明，手势功能在疾病起病阶段即已受损，且可能随病程进展进一步恶化。