Schizophrenia with Onset at the Extremes of Adult Life

David Castle, S. Wessely, R. Howard, R.M. Murray

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    43 Citations (Scopus)


    Objective. To define the epidemiology, phenomenology, premorbid and risk factors in patients with the first manifestation of a schizophrenia-like illness after the age of 60 years, and compare them with patients with an onset before the age of 25 years.Design/setting/subjects. All contacts for a non-affective psychotic illness across all ages of onset were ascertained through a psychiatric case register; patients were rediagnosed according to operationalized criteria for psychotic illness, and those with a very early and very late onset compared.Main outcomes measures. Phenomenological, premorbid and aetiological parameters were compared in the two groups, using risk ratios and 95% confidence intervals.Results. Very late onset patients (N = 72) were, compared to their very early onset counterparts (N = 192), more likely to be female, have good premorbid functioning and developmental history, and to exhibit persecutory delusions and hallucinations; they were less likely to have negative schizophrenic symptoms, to have a positive family history of schizophrenia, or have suffered pregnancy or birth complications.Conclusions. The results highlight premorbid, aetiological and phenomenological differences between patients with the onset of a schizophrenia-like illness at the extremes of adult life, and suggest it is premature to consider the two groups to be merely different manifestations of the same illness. (C) 1997 by John Wiley & Sons, Ltd.
    Original languageEnglish
    Pages (from-to)712-717
    JournalInternational Journal of Geriatric Psychiatry
    Publication statusPublished - 1997


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