Browsing by Author "Esan, O. B."

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A Study of 31 Patients with Primary Complaint of Halitosis in a Tertiary Hospital in South-Western Nigeria.
(College of Medicine, University of Ibadan, 2019) Adeyemi, B.F.; Esan, O. B.; Akinyamoju, A. O.
BACKGROUND: Halitosis is a common cause of dental consultation. Patients presenting with primary complaint of halitosis consist of dissatisfied people with genuine and pseudo-halitosis. OBJECTIVES: To assess the demographic and clinico-pathologic features of patients presenting with primary complaint of halitosis as well as evaluate the treatment outcome. METHODS: Consenting patients presenting with primary complaint of halitosis from 1st of March to 31st August, 2015 were recruited. All had intraoral examination, were screened for psychiatric morbidity and halitosis using the organoleptic method. Data concerning the complaint of halitosis was retrieved from all through an interviewer-administered structured questionnaire. All the patients were educated on the aetiology of halitosis, those with oral disease were treated and all had scaling and polishing, oral hygiene instruction/motivation in addition to hydrogen peroxide mouth rinse for two weeks. Patients’ opinions were sought concerning the presence/ intensity of halitosis at two weeks and six months post treatment. RESULTS: Thirty-one patients with a mean age of 38.48 years and male: female ratio of 1.3 were recruited. Intraoral pathology was observed in 48.4% of patients. None of the patients smoked cigarette or pipe. Twenty patients (64.5%) had been informed of the foulness of their breath by at least one person in the past; the information generated negative feelings in 19 of them. Six patients had psychiatric morbidity which was significantly associated with female gender and presence of body odour. At two weeks post treatment, 54.8% of patients were free of halitosis, while at six months only 25.8% were free. CONCLUSION: The patients who complained of halitosis were non-smokers with a mean age of 38.48±14.0 years. Intraoral pathologies were found in fifteen (15) patients, while six (6) had psychiatry morbidity. About half of the patients and about a quarter were free of halitosis following scaling and polishing and two weeks’ hydrogen peroxide mouth rinse at 2 weeks and 6 months’ reviews, respectively.
Achieving health security in Nigeria: A strategic blueprint for addressing psychoactive substance use
(College of Medicine, University of Ibadan, 2019) Abdulmalik, J.O.; Lasebikan, V.O.; Makanjuola, V.A.; Oshiname, F. O.; Oladeji, B. D.; Esan, O. B.; Bella - Awusah, T. T.; Ojagbemi, A. A.; Adeniyi, Y. P.; Gureje, O.; Omigbodun, O. O.
Introduction: Psychoactive substance use is an important component of health and national security. Nigeria has evolved from a largely transit nation for psychoactive substances to a high consumption nation. Increasing rates of use result in a concurrent rise in crime rates and insecurity, as well as road traffic accidents. The use of psychoactive substances is also implicated in episodes of civil strife, conflicts and wars, such as the ongoing Boko Haram insurgency in North East Nigeria. This observation is likely to worsen over time if there is no coherent and strategic plan to halt and reverse this trend. The forecast portends higher crime rates, heightened insecurity, civil unrest and violent conflicts by 2050, if the rising trend of psychoactive substance use is not reversed. It is a scenario that will not augur well for the stability of Nigeria and the West African region. Methods: A narrative review of the published literature, as well as expert opinion deliberations was utilized to develop a comprehensive analysis of the strategic strengths, weaknesses, opportunities and threats (SWOT) of psychoactive substance use and health security implications for Nigeria. Results: An array of the unique strengths and opportunities are spelt out; along with the inherent weaknesses and threats that should be taken into consideration in mapping out strategies to address the clear and present danger from the rising use of psychoactive substances in Nigeria. Conclusion: Recommended interventions should focus on public awareness campaigns, utilizing behaviour change communication strategies – with a special focus on prevention, mental health promotion activities, training and re-training of regulatory agencies, development and revision of existing policies, as well as better policing and enforcement of access restriction.
Body mass index (BMI) and obesity in Nigerians with schizophrenia
(Taylor & Francis, 2021) Esan, O. B.; Esan, A.
Background: Few Nigerian studies have examined BMI in people with schizophrenia. The aims of the present study were to assess the prevalence and distribution of obesity in Nigerians with schizophrenia and to examine the clinical correlates of BMI and obesity. Methods: A total of 207 people with schizophrenia met the inclusion criteria and were evaluated for BMI. The Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HDRS), Social and Occupational Functioning Assessment Scale (SOFAS) were rated for all participants. Anthropometric measures such as weight and height were taken using a standard protocol. Results: The prevalence of obesity was 12.6%. The non-obese participants were made up of underweight 24 (11.7%), normal weight 118 (57%) and overweight 38 (18.4%). Compared to non-obese participants, obese participants were older, more educated, more likely to be employed, had higher incomes, lower PANSS score (negative subscale), had fewer female participants, and better social and occupational functioning (p<0.05) BMI was positively correlated with age and monthly income. In the adjusted model, age, gender and education were independently associated with obesity while only age was associated with BMI. Conclusion: The present study suggests that unlike in high-income countries, obese patients with schizophrenia in Nigeria have better social and psychological functioning than non-obese patients.
Childhood generalized specific phobia as an early marker of internalizing psychopathology across the lifespan: results from the World Mental Health Surveys
(BioMed Central (BMC), 2019) de Vries, Y. A.; Al-Hamzawi, A.; Alonso, J.; Borges, G.; Bruffaerts, R.; Bunting, B.; Caldas-de-Almeida, J. M.; Cia, A. H.; De Girolamo, G.; Dinolova, R. V.; Esan, O. B.; Florescu, S.; Gureje, O.; Haro, J. M.; Hu, C.; Karam, E. G.; Karam, A.; Kawakami, N.; Kiejna, A.; Kovess-Masfety, V.; WHO World Mental Health Survey Collaborators
Background: Specific phobia (SP) is a relatively common disorder associated with high levels of psychiatric comorbidity. Because of its early onset, SP may be a useful early marker of internalizing psychopathology, especially if generalized to multiple situations. This study aimed to evaluate the association of childhood generalized SP with comorbid internalizing disorders. Methods: We conducted retrospective analyses of the cross-sectional population-based World Mental Health Surveys using the Composite International Diagnostic Interview. Outcomes were lifetime prevalence, age of onset, and persistence of internalizing disorders; past-month disability; lifetime suicidality; and 12-month serious mental illness. Logistic and linear regressions were used to assess the association of these outcomes with the number of subtypes of childhood-onset (< 13 years) SP. Results: Among 123,628 respondents from 25 countries, retrospectively reported prevalence of childhood SP was 5.9%, 56% of whom reported one, 25% two, 10% three, and 8% four or more subtypes. Lifetime prevalence of internalizing disorders increased from 18.2% among those without childhood SP to 46.3% among those with one and 75.6% those with 4+ subtypes (OR=2.4, 95% CI 2.3–2.5, p< 0.001). Conclusions: This large international study shows that childhood-onset generalized SP is related to adverse outcomes in the internalizing domain throughout the life course. Comorbidity, persistence, and severity of internalizing disorders all increased with the number of childhood SP subtypes. Although our study cannot establish whether SP is causally associated with these poor outcomes or whether other factors, such as a shared underlying vulnerability, explain the association, our findings clearly show that childhood generalized SP identifies an important target group for early intervention.
Mental disorders and earnings: results from the Nigerian National Survey of Mental Health and Well-Being (NSMHW)
(International Center of Mental Health Policy and Economics, 2012) Esan, O. B.; Kola, L.; Gureje, O.
Background: Mental disorders are associated with a loss in earnings both at the individual and societal level. Very few studies have addressed the issue of the cost of mental illness in Sub-Saharan Africa. These studies have been largely hospital based, localized, and have addressed only a few mental disorders using very small sample sizes. Aims of the Study: To examine the impact of mental disorders on earnings of affected persons. Methods: Mental disorders on and personal earnings were assessed in a representative sample of 1,889 Nigerians aged 18-64 years in an epidemiological survey. Version 3.0 of the World Health Organization Composite International Diagnostic Interview (WHO CIDI) was used to assess mental disorders. Respondents were also asked to report their personal earnings before tax in the past 12 months, while authors predicted personal earnings in the same period from information about 12 month and life time DSM IV mental disorders among respondents. Results: A 12-month prevalence of Serious Mental Illness (SMI) was found in 0.5% of the sample while other 12-month disorders had a prevalence of 4.83%. The prevalence of other lifetime disorders was 4.14%. The mean annual impact of serious mental illness was 60,126 Naira (US$ 463). At the level of the society the annual impact was 21.6 billion Naira (US$ 166.2 million). Discussion: Mental disorders have an enormous individual and societal financial burden. This impact appears more severe in males. Implications for Health Care Provision and Use: Mental disorders have enormous negative impacts on earnings both at the individual and societal level. This analysis highlights the financial value of lost earnings in the absence of such disorders. Implications for Health Policies: An increase in spending on mental health based on proportionate economic burden of mental disorders may substantially reduce financial losses due to mental disorders. Implications for Further Research: In the present study, only the indirect health care costs have been assessed. Future research should consider direct costs.
Mental health and wellbeing of medical students in Nigeria. A systematic review
(Taylor & Francis, 2019) Esan, O. B.; Esan, A.; Folasire, A.; Oluwajulugbe, P.
In additional peculiar contemporary social problems due to income inequality, poverty, insecurity and political instability. These have a direct impact on their mental health and wellbeing. The aim of this study was to systematically review articles reporting on the epidemiology of psychiatric disorders among medical students in Nigeria. Studies were identified using MEDLINE, HINARI, African Journal Online (AJOL) and Google Scholar databases using search terms encompassing psychiatric morbidity amongst medical students. No date restrictions were applied to the search. The pooled prevalence estimate was calculated for each disorder. Psychological dis tress was present in 25.2% of the students, perceived stress in 60.5%, depression in 33.5% and anxiety in 28.8%. The current use of at least one psychoactive substance was present in up to 44.2%, while 35.5% of all the respondents had experienced one or more forms of abuse during their training as medical students. The prevalence of psychiatric disorders among medical stu dents in Nigeria is high. Positive coping mechanisms such as religiosity, positive reframing and resilience which were identified in this review should be optimized to reduce the burden.
Modeling psychological function in patients with schizophrenia with the PANSS: an international multi-center study
(Cambridge University Press, 2021) Fountoulakis, K. N.; Dragioti, E.; Theofilidis, A. T.; Wiklund, T.; Atmatzidis, X.; Nimatoudis, I.; Thys, E.; Wampers, M.; Hranov, L.; Hristova, T.; Aptalidis, D.; Milev, R.; Iftene, F.; Spaniel, F.; Knytl, P.; Furstova, P.; From, T.; Karlsson, H.; Walta, M.; Esan, O. B.; Oladele, O.; Osunbote, C.; Rybakowski, J. K.; Wojciak P.
Background: The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model. Methods: Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed. Results: The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage. Conclusions: The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.
Neurocognitive Impairments (NCI) in bipolar disorder: Comparison with schizophrenia and healthy controls
(Elsevier B.V, 2020) Esan, O. B.; Oladele, O.; Adediran, K. I.; Abiona, T. O.
Background: Neurocognitive impairments (NCI) are common in patients with bipolar I disorder. However, reports about the affected domains, outcomes and magnitude have been inconsistent. The aim of this study was to compare the magnitude (severity) and specificity (domains), of (NCI) in euthymic Bipolar I Disorder (BD) patients with a demographically and educationally matched sample of patients with schizophrenia in remission (SC) and healthy controls (HC). Methods: The Screen for Cognitive Impairment in Psychiatry (SCIP) was applied in this cross-sectional study, to all consecutive and consenting euthymic outpatients with bipolar I disorder (BD) (n = 76), remitted patients with schizophrenia (n = 130) and age and gender-matched healthy controls (HC) (n = 100). The cognitive tests done included Verbal List Learning-Immediate (VLT-I), Working Memory Test (WMT), Verbal Fluency Test (VFT), Verbal Learning Test-Delayed (VLT-D) and Processing Speed Test (PST). Within the bipolar group, the association between NCI and functioning was assessed. Results: There was a significant difference in the proportions of participants that had cognitive impairment from the 3 groups (37% (HC) vs. 71.1% (BD) vs. 91.5%(SC) (p=0.001) The BD group in comparison to the HCs did worse on all domains of the SCIP except WMT and PST. The BD group was not significantly different from the SC group in all neuropsychological domains of the SCIP except WMT. BD group significantly functions better than the SC group. The severity of depressive symptomatology and VLT-I were independent predictors of functioning in the BD group. Conclusion: Cognitive impairment affects almost all the neurocognitive domains of the BD group. The difference in NCI between euthymic BD patients and SC in remission are quantitative rather than qualitative.
Optimal mental health for achieving health security in Nigeria: a strategic blueprint
(College of Medicine, University of Ibadan, 2019) Ojagbemi, A. A.; Abdulmalik, J. O.; Lasebikan, V. O.; Oladeji, B. D.; Makanjuola, V. A.; Esan, O. B.; Bella - Awusah, T. T.; Adeniyi, Y. P.; Gureje, O.; Omigbodun, O.O.
Objectives: Optimal mental health refers to ‘a state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make contributions to his or her own community’. As such, the catchphrase ‘No health without mental health’ is not just a slogan but an acknowledgement of the importance of mental health in the drive to improve overall wellbeing and productive participation in community and economic activities. Methods: We combined an overview of current literature with opinions of key experts from different sub specialties of mental health practice and present an analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT) to optimal mental health as a strategy to attaining health security in Nigeria by 2050. We also offered recommendations for feasible strategies to optimize mental health. Results: There is poor mental health coverage in Nigeria, with over 80% of persons coping with mental health problems remaining untreated in their lifetime. Also, only about 3% of the National health budget is allocated to mental health and this is mostly focused on large psychiatric institutions to the exclusion of primary health care (PHC) services. Conclusions: In recognition of the critical role of optimal mental health to global development, the Sustainable Development Goals (SDGs) has mental health firmly covered in its third goal, ‘Health and Well-being’. The SDGs further envision a better world in which, in tandem with the WHO definition of health, “physical, mental and social wellbeing are assured”. Thus, the identification and implementation of strategies to promote optimal mental health for all Nigerians is vital for ensuring health security and national development.
Panic disorder prevalence among patients referred for an electrocardiogram in a Nigerian teaching hospital
(Elsevier Inc, 2013) Esan, O. B.; Baiyewu, O.
Background: Panic disorder is a common chronic illness that is often unrecognized, misdiagnosed, and untreated because it often presents to the physicians with symptoms that are similar to those of emergency medical conditions. One study of the prevalence of panic disorder in the general population in Nigeria has been published, but no studies have examined the prevalence of panic disorder in a sample of Nigerian patients with cardiac symptoms. This study investigated the 12-month prevalence of panic disorder among patients who were referred for an electro cardiogram in a Nigerian teaching hospital. Methods: Three hundred consecutive patients who were referred for an electrocardiogram were assessed for panic disorder using the Structured Clinical Interview for DSM-IV (SCID). Results: The prevalence of panic attacks and panic disorder were 10.0% and 7.0%, respectively. Age was associated with the presence of both panic attacks and panic disorder. Conclusions: This study suggests that panic disorder is common among patients who are referred for an electrocardiogram. It is recommended that patients whose cardiovascular or respiratory symptoms are not well explained by the diseases of such systems be evaluated for mental illness.
Partnership for mental health development in Sub-Saharan Africa (PaM-D): a collaborative initiative for research and capacity building
(Cambridge University Press & Assessment, 2019) Gureje, O.; Seedat, S.; Kola, L.; Appiah-Poku, J.; Othieno, C.; Harris, B.; Makanjuola, V.; Price, L.N.; Ayinde, O. O.; Esan, O. B.
Aims In low and middleincome countries (LMIC) in general and sub-Saharan African (SSA) countries in particular, there is both a large treatment gap for mental disorders and a relative paucity of empirical evidence about how to fill this gap. This is more so for severe mental disorders, such as psychosis, which impose an additional vulnerability for human rights abuse on its sufferers. A major factor for the lack of evidence is the few numbers of active mental health (MH) researchers on the continent and the distance between the little evidence generated and the policymaking process. Methods: The Partnership for Mental Health Development in Africa (PaMD) aimed to bring together diverse MH stakeholders in SSA, working collaboratively with colleagues from the global north, to create an infrastructure to develop MH research capacity in SSA, advance global MH science by conducting innovative public health relevant MH research in the region and work to link research to policy development. Participating SSA countries were Ghana, Kenya, Liberia, Nigeria and South Africa. The research component of PaMD focused on the development and assessment of a collaborative shared care (CSC) program between traditional and faith healers (T&FHs) and biomedical providers for the treatment of psychotic disorders, as a way of improving the outcome of persons suffering from these conditions. The capacity building component aimed to develop research capacity and appreciation of the value of research in a broad range of stakeholders through bespoke workshops and fellowships targeting specific skillsets as well as mentoring for early career researchers. Results: In the research component of PaMD, a series of formative studies were implemented to inform the development of an intervention package consisting of the essential features of a CSC for psychosis implemented by primary care providers and T&FHs. A cluster rand was next designed to test the effectiveness of this package on the outcome of psychosis. In the capacity building component, 35 early and midcareer researchers participated in the training workshops and several established mentor mentee relationships with senior PaMD members. At the end of the funding period, 60 papers have been published and 21 successful grant applications made. CONCLUSION: The success of PaMD in energising young researchers and implementing a cutting-edge research program attests to the importance of partnership among researchers in the global south working with those from the north in developing MH research and service in LMIC.
Prevalence and correlates of major depressive disorder (MDD) among adolescent patients with epilepsy attending a Nigerian neuropsychiatric hospital
(Elsevier, 2016) Fela-Thomas, A.; Akinhanmi, A.; Esan, O. B.
Background: A high prevalence of mood disorders exists in patients with epilepsy. In most cases, this is not detected and, consequently, not treated. This study aimed to determine the prevalence and correlates of major depressive disorder (MDD) among adolescents with epilepsy attending a child and adolescent clinic in Nigeria. Methods: We recruited 156 participants consecutively for the study. Adherence was assessed using the 8 item Morisky Medication Adherence Questionnaire, while the K-SADS was used to assess the presence of major depressive disorder. Seizure control was evaluated by the frequency of seizures within a year. Results: Major depressive disorder (DSM-IV criteria) was diagnosed in 28.2% of the participants. The age of participants (p = 0.013), seizure control (p = 0.03), medication adherence (p = 0.045), frequency of seizures in the preceding 4 weeks (p b 0.001), and duration of illness (p b 0.001) were all significantly associated with the presence of MDD. Participants with seizures occurring more than once weekly in the preceding 4 weeks were 16 times more likely to have a MDD compared with those with no seizures in the preceding 4 weeks (p b 0.001, 95% C.I. [4.13, 65.43]), while participants with a duration of illness morethan10yearsweremorethanfourtimeslikelytohaveMDDcomparedwiththosewithanillnessdu ration of 5–10 years (p b 0.01, 95% C.I. [0.07, 0.70]). Conclusion: The prevalence of MDD among patients with epilepsy was high. Poor seizure control, poor medication adherence, and long duration of illness were associated with the presence of MDD among such patients. Intervention should focus on ensuring good seizure control and optimal adherence in order to mitigate the impact of MDD in patients with epilepsy
Searching for psychosis: INTREPID (1): systems for detecting untreated and first-episode cases of psychosis in diverse settings
(Springer Science + Business Media, 2015) Morgan, C.; Hibben, M.; Esan, O. B.; John, S.; Patel, V.; Weiss,H.A.; Murray, R.M.; Hutchinson, G.; Gureje, O.; Thara, R.; Cohen, A.
Purpose: Our understanding of psychotic disorders is largely based on studies conducted in North America, Europe and Australasia. Few methodologically robust and comparable studies have been carried out in other settings. INTREPID is a programme of research on psychoses in India, Nigeria, and Trinidad. As a platform for INTREPID, we sought to establish comprehensive systems for detecting representative samples of cases of psychosis by mapping and seeking to engage all professional and folk (traditional) providers and potential key informants in defined catchment areas. Method: We used a combination of official sources, local knowledge of principal investigators, and snowballing techniques. Results: The structure of the mental health systems in each catchment area was similar, but the content (i.e., type, extent, and nature) differed. Tunapuna–Piarco (Trinidad), for example, has the most comprehensive and accessible professional services. By contrast, Ibadan (Nigeria) has the most extensive folk (traditional) sector. We identified and engaged in our detection system—(a) all professional mental health services in each site (in- and outpatient services—Chengalpet, 6; Ibadan, 3; Trinidad, 5); (b) a wide range of folk providers (Chengalpet, 3 major healing sites; Ibadan, 19 healers; Trinidad: 12 healers); and c) a number of key informants, depending on need (Chengalpet, 361; Ibadan, 54; Trinidad, 1). Conclusions: Marked differences in mental health systems in each catchment area illustrate the necessity of devel oping tailored systems for the detection of representative samples of cases with untreated and first-episode psychosis as a basis for robust, comparative epidemiological studies.
Sexual Dysfunction Among Patients With Schizophrenia in Southwest Nigeria
(Routledge (Taylor & Francis Group), 2018) Esan, O. B.; Esan,A.
Sexual functioning has received little attention as an important aspect of patient care for those suffering from schizophrenia. In Nigeria, cultural and religious factors often prevent patients from talking with their clinician about their sexual life. The aim of our study was to assess the frequency and nature of sexual dysfunction inpatients with schizophrenia and assess the determinants of sexual dysfunction in such patients. Sexual dysfunction was assessed with the Arizona Sexual Experience Scale in 90 patients with schizophrenia. Demographic and clinical characteristics including quality of life, the severity of schizophrenia, and perceived stigma were recorded using a standardized protocol and at a collection. The prevalence of sexual dysfunction was 36.7%. Higher scores on the negative subscale of the Positive and Negative Syndrome Scale (PANSS), the general subscale of the PANSS, the total scores on the PANSS, and a family history of mental illness were significantly associated with sexual dysfunction. The only significant predictor of sexual dysfunction was the severity of the negative subscale of the PANSS. This study highlights the high prevalence of sexual dysfunction among patients with schizophrenia. Efforts should be made to identify and address this problem.
Spirituality and Suicidality Among Patients with Schizophrenia: A Cross-sectional Study from Nigeria
(Springer Science+Business Media / Springer Nature, 2021) Esan, O. B.; Lawal, K.
Studies which have explored the effect of spirituality on suicidality among patients with schizophrenia have been characterized by inconsistent results. The aim of this study was to examine the relationship between spirituality and suicidality among stable patients with schizophrenia in Nigeria. The Daily Spiritual Experience Scale was applied to measure spirituality. There was found a significant relationship between spirituality and having had suicidal thoughts in a lifetime. Spirituality was negatively correlated with the severity of negative symptoms, total positive and negative syndrome scale score (PANSS), the severity of depression, and positively correlated with functioning.
Spontaneous and emergent extrapyramidal syndromes in Black Africans with first-episode schizophrenia and first exposure to antipsychotics
(Taylor & Francis, 2021) Ojagbemi, A.; Chiliza, B.; Bello, T.; Esan, O. B.; Asmal, L.; Emsley, R.; Gureje, O.
Background: Persons of African ancestry are thought to carry a higher risk for extrapyramidal syndromes (EPS) in schizophrenia. Aim: We investigated the phenomenon of spontaneous and treatment-emergent EPS in a sample comprising Xhosa (South Africa) and Yoruba (Nigeria) Africans with first-episode schizophrenia and first exposure to antipsychotics. Methods: The Extrapyramidal Symptom Rating Scale (ESRS) and a variety of validated tools were used for the assessment of participants before, and two-weekly after treatment with low dose flupenthixol decanoate. Participants were followed up for 12 months. Association of EPS with clinical characteristics was investigated using Pearson’s correlation and linear regression analyses. Results: Of 88 participants at baseline, 16 (18.1%) had at least one definite EPS prior to antipsychotic exposure and 34 (38.6%) had treatment-emergent EPS. While spontaneous Parkinsonism was associated with negative symptoms (r¼0.2, p¼0.043; b¼0.6, p¼0.043), treatment-emergent EPS demonstrated non-significant correlations with clinical characteristics. Apart from dyskinesia, the frequency of treatment-emergent EPS decreased over 12 months observation. Conclusion: These findings support the hypothesis suggesting that spontaneously occurring Parkinsonism in schizophrenia may be the motor spectrum of negative symptomatology. Future studies of this relationship may lead to early identification of patients who may be more sensitive to EPS.