Age at onset and sex differences in the age at onset were investigated in the schizophrenic subtypes of 200 patients. Significant differences in the age at onset were observed among these subtypes; the disorganized subtype demonstrated the earliest and the paranoid the latest onset. The mean age at onset of all female patients was significantly greater than that of the male. Specifically, in the paranoid subtype the onset for men occurred earlier than for women. Conversely, in the disorganized subtype the disorder appeared earlier in women. There was no significant sex difference in the age at onset in the undifferentiated and the residual subtypes. In the paranoid subtype most men developed the disease before age 30 (72%), whereas women had an even distribution of the onset before and after 30. Ninety-six patients admitted for the first time demonstrated findings similar to those of the total sample. The data provide additional information on the phenotypic expression of the subtypes of schizophrenic disorders and indicate the necessity for further demographic and genetic studies to delineate the underlying defect.
We describe the case of a patient who, after a traumatic experience at the age of 12, had a series of anniversary depressive episodes at 16, 17, 18 and 19 years of age, followed by a series of anniversary manic episodes at the ages of 21,23, 24, 25 and 26 years. All of these episodes occurred almost always a few days before or after the date of the accident and only when the patient was residing in his home town, the place of the traumatic event. The case fulfills the DSM-III-R criteria for seasonal mood disorder, but differs from previously described cases in that: (a) both depressive and manic episodes developed at the same time of the year, and (b) the illness was precipitated by psychosocial factors rather than climatic conditions.
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