Is late‐onset schizophrenia a subtype of schizophrenia?

Vahia, Ipsit V.; Palmer, Barton W.; Depp, Colin A.; Fellows, Ian E.; Golshan, Shahrokh; Kraemer, Helena C.; Jeste, Dilip V.

doi:10.1111/j.1600-0447.2010.01552.x

Cited by 107 publications

(99 citation statements)

References 86 publications

(107 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies attempting to identify other features that differentiate late-versus-early-onset bipolar disorder and schizophrenia have only found relatively subtle differences, including less severe psychopathology in late-onset disorders. 17 Findings on cognitive assessment have been variable, with some studies finding less cognitive impairment 17 and others finding more cognitive impairment 18 in late-onset compared with younger-onset patients. Some studies have found a lower incidence of family history of psychiatric disease in late-onset cases.…”

Section: Discussionmentioning

confidence: 99%

P1‐196: Frontotemporal Dementia and Psychiatric Illness: Emerging Clinical and Biological Links in Gene Carriers

Block

Sha

Karydas

et al. 2014

Alzheimer's & Dementia

View full text Add to dashboard Cite

Objective-To describe psychiatric presentations in individuals with genetic mutations causing frontotemporal dementia (FTD).Design-Case descriptions from five carriers of FTD-related gene mutations with symptoms associated with non-neurodegenerative psychiatric disease.Setting-A comprehensive research program investigating genetic and non-genetic FTD at the University of California, San Francisco Memory and Aging Center. Participants-Three probands and two non-proband gene carriers.Measurements-Medical history and neurological examination, neuropsychological testing, MR and/or PET imaging, and a genetic analysis to screen for dementia-related mutations. Genetic status was unknown at the time of initial evaluation.

show abstract

Section: Discussionmentioning

confidence: 99%

P1‐196: Frontotemporal Dementia and Psychiatric Illness: Emerging Clinical and Biological Links in Gene Carriers

Block

Sha

Karydas

et al. 2014

Alzheimer's & Dementia

View full text Add to dashboard Cite

show abstract

“…Kot pri EOS nekatere publikacije uporabljajo starostno mejo 45 ali 50 let (1,(3)(4)(5)(6)(7)(8)(9). V literaturi se pojavljajo še druga imena: pozna parafrenija ali senilna shizofrenija (10). Zelo pozno nastala shizofreniji podobna psihoza (angl.…”

Section: Definicijeunclassified

“…V primerjavi s kontrolno skupino je med bolniki z LOS večja prevalenca tistih, ki nikoli niso bili poročeni ali pa so ločeni (10,12). Poznanih je že veliko genetskih dejavnikov pri pozno nastali shizofreniji, potrjeni pa so le pri majhnem deležu bolnikov.…”

Section: Dejavniki Tveganjaunclassified

“…Spomin je ena najbolj prizadetih kognitivnih funkcij, predvsem deficiti v semantičnem in epizodičnem spominu, a tudi v vidno-prostorskem in fonološkem delovnem spominu (6). Bolniki z LOS so manj prizadeti na področju abstraktnega mišljenja, fleksibilnosti mišljenja ter v semantičnem spominu, imajo tudi boljšo procesno hitrost in verbalni spomin (1,10). Kognitivni deficiti so med glavnimi lastnostmi shizofrenije in so pomembni za napoved izida bolezni ter funkcijske nezmožnosti posameznikov (6).…”

Section: Kognicijaunclassified

“…Najpogosteje se uporabljata olanzapin in risperidon, prvi v začetnih odmerkih 2,5 mg enkrat na dan, drugi pa od 0,5 mg enkrat na dan naprej. Začetni dnevni odmerki so nižji, potrebno pa jih je postopno povečevati in ob tem spremljati učinek in neželene učinke zdravila (1,(3)(4)(5)9,10,18,22). Priporoče-no je rutinsko spremljanje prehrane in telesne teže, beleženje EKG (možno podaljšanje QTc intervala), pozornost na padce in ekstrapiramidne neželene učinke, spremljanje plazemske koncentracije prolaktina (osteoporoza), lipidov in glukoze (tveganje za nastanek na inzulin odporne sladkorne bolezni) (5).…”

Section: Zdravljenjeunclassified

See 2 more Smart Citations

Shizofrenija z začetkom v poznem življenjskem obdobju

2018

View full text Add to dashboard Cite

IzvlečekPozno nastala shizofrenija je v zadnjih letih predmet kontroverzne razprave v medicinski stroki predvsem zaradi težave pri doseganju konsenza glede postavitve same diagnoze. V članku skušamo na enem mestu pregledno povzeti znanstvene vire, nastale v preteklih desetletjih, in podati celostni pregled od diagnoze do zdravljenja te dokaj pogoste bolezni. Od zgodaj nastale shizofrenije se pozno nastala razlikuje po simptomih, zdravljenju, napovedi izida ter patogenezi, v kateri naj bi pri zgodaj nastali prevladovala motnja v razvoju, medtem ko gre pri pozno nastali po vsej verjetnosti za degenerativen proces znotraj centralnega živčnega sistema. Posebna pozornost pa je potrebna pri diferencialnodiagnostični obravnavi bolnikov, pri katerih sumimo, da gre za to bolezen. Izključiti je namreč potrebno degenerativne bolezni, ekspanzivne procese, nevrološke in psihiatrične motnje ter nazadnje tudi zlorabo psihoaktivnih snovi. V zadnjem času je veliko raziskav tudi s področja vloge genetike v patogenezi bolezni, vendar pa je poznavanje genetskega vpliva za klinično diagnostiko v tem trenutku še nezadostno. Zlati standard pri diagnosticiranju pozno nastale shizofrenije tako še naprej ostaja klinični pregled bolnika. Za konec pa smo poudarili tudi posebnosti farmakoterapije ter povzeli aktualne smernice zdravljenja pozno nastale shizofrenije. AbstractIn recent years, late-onset schizophrenia is a subject of controversial debate in the medical profession largely due to difficulties in reaching a consensus on the diagnosis of the disorder. In the present article we try to summarize in one place the scientific resources that were studying this disorder in the past decades and present a comprehensive overview from diagnosis to treatment of this relatively common disorder. Late-onset schizophrenia differs from early-onset schizophrenia in terms of symptoms, treatment, prognosis and pathogenesis, which is in early-onset schizophrenia based mainly on the developmental causes, whereas late-onset schizophrenia is most likely the result of a degenerative process within the central nervous system. Differential diagnosis of this disorder can be especially challenging and therefore demands additional attention. It is necessary to exclude degenerative diseases, expansive processes, neurological and psychiatric disorders, and ultimately, the abuse of psychoactive substances. Lately, there has been a lot of research done on genetic causes that could explain pathogenesis of the disorder, however, knowledge of the genetic influence for the establishment of clinical diagnosis is at this moment still inadequate. Thus, a clinical examination of the patient still remains the gold standard for the diagnosis of late-onset schizophrenia.. Finally, we highlight the particularities of pharmacotherapy and summarize the current treatment guidelines for late-onset schizophrenia.

show abstract

Self-Harm and Suicide Rates Before and After an Early Intervention Program for Patients With First-Episode Schizophrenia

Chai,

Tang,

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceEvidence on the association of early intervention services (EISs) with self-harm and suicide among patients with first-episode schizophrenia (FES) at older than 25 years is lacking.ObjectiveTo examine changes in self-harm and suicide rates among patients with FES before and after the implementation of an EIS program.Design, Setting, and ParticipantsThis population-based cohort study conducted among 37 040 patients aged 15 to 64 years with FES between January 1, 2001, and March 31, 2020, used electronic medical records from the Hong Kong Clinical Data Analysis and Reporting System. All patients were followed up from the first diagnosis of schizophrenia (the index date) until the date of their death or the end of the study period (March 31, 2021), whichever came first. Statistical analysis was performed from July to November 2023.ExposureThe EIS extended the Early Assessment Service for Young People With Early Psychosis (EASY) program from patients aged 15 to 25 years to those aged 15 to 64 years (EASY Plus). The exposure was the implementation of the EASY Plus program in April 2011. The exposure period was defined as between April 2012 and March 2021 for the 1-year-time-lag analysis.Main Outcomes and MeasuresThe outcomes were monthly rates of self-harm and suicide among patients with FES before and after the implementation of the EASY Plus program. Interrupted time series analysis was used for the main analysis.ResultsThis study included 37 040 patients with FES (mean [SD] age at onset, 39 [12] years; 82.6% older than 25 years; 53.0% female patients). The 1-year-time-lag analysis found an immediate decrease in self-harm rates among patients aged 26 to 44 years (rate ratio [RR], 0.77 [95% CI, 0.59-1.00]) and 45 to 64 years (RR, 0.70 [95% CI, 0.49-1.00]) and among male patients (RR, 0.71 [95% CI, 0.56-0.91]). A significant long-term decrease in self-harm rates was found for all patients with FES (patients aged 15-25 years: RR, 0.98 [95% CI, 0.97-1.00]; patients aged 26-44 years: RR, 0.98 [95% CI, 0.97-0.99]; patients aged 45-64 years: RR, 0.97 [95% CI, 0.96-0.98]). Suicide rates decreased immediately after the implementation of the EASY Plus program among patients aged 15 to 25 years (RR, 0.33 [95% CI, 0.14-0.77]) and 26 to 44 years (RR, 0.38 [95% CI, 0.20-0.73]). Compared with the counterfactual scenario, the EASY Plus program might have led to 6302 fewer self-harm episodes among patients aged 26 to 44 years.Conclusions and RelevanceThis cohort study of the EASY Plus program suggests that the extended EIS was associated with reduced self-harm and suicide rates among all patients with FES, including those older than 25 years. These findings emphasize the importance of developing tailored interventions for patients across all age ranges to maximize the benefits of EISs.

show abstract

Is late‐onset schizophrenia a subtype of schizophrenia?

Cited by 107 publications

References 86 publications

P1‐196: Frontotemporal Dementia and Psychiatric Illness: Emerging Clinical and Biological Links in Gene Carriers

P1‐196: Frontotemporal Dementia and Psychiatric Illness: Emerging Clinical and Biological Links in Gene Carriers

Shizofrenija z začetkom v poznem življenjskem obdobju

Self-Harm and Suicide Rates Before and After an Early Intervention Program for Patients With First-Episode Schizophrenia

Contact Info

Product

Resources

About