Thursday, 21 August 2003
This presentation is part of : Late Onset Schizophrenia: New Wine in Old Bottle

S082-001 Cross-Sectional and Longitudinal Comparison of Late-Onset and Early-Onset Schizophrenia Patients

Dilip Jeste, University of California, San Diego, San Diego, CA, USA

Background: Onset of schizophrenia in middle or old age continues to be a controversial topic, especially in the USA. Here we report the results of a large study comparing late-onset and early-onset schizophrenia among community-dwelling patients with schizophrenia.

Methods: We have studied 70 patients with late-onset schizophrenia (i.e., with onset of illness after age 40) and 243 with early-onset schizophrenia (i.e., with onset of illness before age 40). All these patients were older than 40 at the time of their baseline assessment in our Center, and were living in the community. Diagnosis of schizophrenia was based on DSM-III-R or DSM-IV criteria, and age of onset of illness was defined as age of onset of prodromal symptoms. Patients received comprehensive sociodemographic, psychopathological, neuropsychological, and functional assessments at baseline and at annual follow-up visits.

Results: There were several similarities between the late-onset and early-onset schizophrenia patients in severity of positive symptoms, course of illness, and qualititative response to treatment. The late-onset group differed from the early-onset group in having a larger proportion of women, lower severity of negative symptoms, an over-representation of paranoid subtype, lower daily neuroleptic dose, and better cognitive performance (especially in terms of learning). On follow-up, both the groups showed a slight improvement in cognitive performance, which was probably a reflection of practice effect.

Conclusion: Late-onset schizophrenia seems to be a distinct subtype of schizophrenia, with both similarities with and differences from early-onset schizophrenia in specific areas.

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