Is schizophrenia a disorder of all ages? A comparison of first episodes and early course across the life-cycle

Häfner, Heinz; Hambrecht, Martin; Löffler, W.; Munk‐Jørgensen, Povl; Riecher-Rössler, Anita

doi:10.1017/s0033291797006399

Cited by 148 publications

(100 citation statements)

References 39 publications

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“…10 The anti-dopaminergic effect of oestrogen has been postulated as conferring some protection for premenopausal women who are genetically predisposed to developing schizophrenia. 15, 16 Häfner at al 15 have suggested, therefore, that oestrogens may modulate both the age distribution of onset, and symptom severity in women, but not in men. According to this hypothesis, the presence of oestrogen should potentially delay the onset of psychosis in vulnerable women, or attenuate symptom severity in women with an early onset of illness, at least until after the menopause.…”

Section: Epidemiology Diagnostic Issues and Possible Risk Factorsmentioning

confidence: 99%

“…Roth's intention was to emphasize that these elderly patients did not deteriorate over time like many early-onset patients. Expanding on this issue, Häfner et al 15 suggested that, when psychotic symptoms emerge for the first time in later life, the person's more mature coping abilities and established personality style might have an ameliorating influence on thought disorder and the frequency of negative symptoms.…”

Section: Clinical Presentationmentioning

confidence: 99%

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Schizophrenia and delusional disorders with onset in later life

Hassett

2002

Rev. Bras. Psiquiatr.

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Keywords Resumo DescritoresSchizophrenia-spectrum illness is most commonly associated with an onset in early adulthood. When nonaffective psychotic symptoms emerge for the first time in later life, the clinical presentation has both similarities and differences with earlier-onset syndromes. This situation has resulted in continuing debate about the nosological status of late-onset psychosis, and whether there are particular risk factors associated with this latelife peak in incidence. Although early cognitive decline is frequently identified in these patients, studies, to date, have not established if there is a relationship with the dementing illnesses of old age. Sensory impairment, social isolation, and a family history of schizophrenia have been associated with late-onset psychosis, but appear to exert a nonspecific influence on vulnerability. While diagnostic issues remain unresolved, clinicians need to formulate treatment strategies that most appropriately address the constellation of symptoms in the clinical presentation of their psychotic elderly patients.Schizophrenia. Psychotic disorders. Psychoses. Cognition. Social isolation. Aged. Transtornos mentais do espectro da esquizofrenia são comumente associados a início na primeira fase da vida adulta. Quando sintomas psicóticos não-afetivos emergem pela primeira vez em fases tardias da vida, a apresentação clínica tem semelhanças e diferenças em relação às

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Section: Epidemiology Diagnostic Issues and Possible Risk Factorsmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Schizophrenia and delusional disorders with onset in later life

Hassett

2002

Rev. Bras. Psiquiatr.

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“…Underneath this 'normalization', however, there is a silently, slowly and nondramatically progressing deterioration of cognitive functioning. [2][3][4][5] This deterioration shows gradual differences among patients with the most severely affected individuals representing Kraepelin's 'dementia praecox'. 6 Brain atrophy and ventricular enlargement as morphological substrates of this continuous cognitive decline have been suspected for decades using autopsy material and imaging studies.…”

Section: Introductionmentioning

confidence: 99%

Erythropoietin: a candidate compound for neuroprotection in schizophrenia

et al. 2003

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Erythropoietin (EPO) is a candidate compound for neuroprotection in human brain disease capable of combating a spectrum of pathophysiological processes operational during the progression of schizophrenic psychosis. The purpose of the present study was to prepare the ground for its application in a first neuroprotective add-on strategy in schizophrenia, aiming at improvement of cognitive brain function as well as prevention/slowing of degenerative processes. Using rodent studies, primary hippocampal neurons in culture, immunohistochemical analysis of human post-mortem brain tissue and nuclear imaging technology in man, we demonstrate that: (1) peripherally applied recombinant human (rh) EPO penetrates into the brain efficiently both in rat and humans, (2) rhEPO is enriched intracranially in healthy men and more distinctly in schizophrenic patients, (3) EPO receptors are densely expressed in hippocampus and cortex of schizophrenic subjects but distinctly less in controls, (4) rhEPO attenuates the haloperidol-induced neuronal death in vitro, and (4) peripherally administered rhEPO enhances cognitive functioning in mice in the context of an aversion task involving cortical and subcortical pathways presumably affected in schizophrenia. These observations, together with the known safety of rhEPO, render it an interesting compound for neuroprotective add-on strategies in schizophrenia and other human diseases characterized by a progressive decline in cognitive performance.

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“…En varios estudios se ha reportado que las mujeres presentan inicio más tardío y menor gravedad de la enfermedad (6)(7)(8)(9). Además, en hombres se ha encontrado un peor funcionamiento premórbido, más síntomas negativos y cognoscitivos, así como una mayor frecuencia de anormalidades cerebrales estructurales o trastornos neuropsicológicos (10).…”

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Edad de inicio de los síntomas y sexo en pacientes con trastorno del espectro esquizofrénico

Sánchez¹,

Téllez²,

Jaramillo³

2012

biomedica

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Edad de inicio de los síntomas y sexo en pacientes con trastorno del espectro esquizofrénicoIntroducción. Existe controversia sobre la posibilidad de que la edad de inicio de la esquizofrenia y de algunas características clínicas del trastorno, sean diferentes entre hombres y mujeres. Objetivo. Evaluar la relación entre sexo, edad de inicio y síntomas negativos en pacientes con trastornos del espectro esquizofrénico. Materiales y métodos. Se evaluaron 225 pacientes para medir la edad de inicio de los síntomas y el puntaje en la escala SANS (Scale for the Assessment of Negative Symptoms). Se usaron estimadores de densidad kernel para evaluar las características de la edad de inicio. Se estimaron los parámetros de distribuciones mezcladas usando algoritmos de máxima verosimilitud. La relación síntomas negativosedad de inicio se evaluó usando regresión múltiple.Resultados. Hubo diferencia significativa en la edad de inicio según el sexo (24,5 años en hombres Vs. 27,5 años en mujeres). Se encontró asociación entre sexo y comienzo temprano de síntomas, siendo este último más frecuente en hombres. Los estimadores de densidad para la edad de inicio sugieren un modelo mezclado con tres componentes, con los siguientes parámetros: m1=21,55, sd1=5,25; m2=29,54, sd2=7,22; y m3=40,01, sd3=3,98. Al tener en cuenta el sexo, se aíslan dos estructuras bimodales: la de hombres tiene la menor media de edad de inicio (18,02 años) mientras que la de media más alta corresponde a las mujeres (41,03 años). Los coeficientes de regresión sugieren incremento en los síntomas negativos a medida que aumenta el tiempo con enfermedad. Conclusión. Nuestros resultados apoyan la hipótesis de que existe relación entre la edad de inicio de los síntomas, el sexo y las características clínicas, en pacientes con trastornos del espectro esquizofrénico, lo que demuestra que los hombres tienen un inicio más temprano y un curso de la enfermedad con mayor deterioro.Palabras clave: esquizofrenia y trastornos con características psicóticas/epidemiología, edad de inicio, distribución por edad y sexo, incidencia, prevalencia, resultado del tratamiento, modelos estadísticos. Age of onset symptoms and gender in schizophrenic spectrum disordersIntroduction. Some controversy exists concerning whether the onset of schizophrenia and some clinical characteristics of the disorder are different between males and females. Objective. The relationship between sex, age at onset and negative symptoms was evaluated in patients with schizophrenic spectrum disorders. Materials and methods. A sample of 225 patients (89 women and 136 men) were diagnosed for schizophrenia between 2008 and 2009. Each was compared for age at onset of symptoms and SANS score (Scale for the Assessment of Negative Symptoms). Kernel density estimators were used to evaluate characteristics of age of onset with respect to gender. Parameters of the mixed distributions were estimated via maximum-likelihood algorithms. Relationships between negative symptoms score and age of onset were evaluated using multi...

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Is schizophrenia a disorder of all ages? A comparison of first episodes and early course across the life-cycle

Cited by 148 publications

References 39 publications

Schizophrenia and delusional disorders with onset in later life

Schizophrenia and delusional disorders with onset in later life

Erythropoietin: a candidate compound for neuroprotection in schizophrenia

Edad de inicio de los síntomas y sexo en pacientes con trastorno del espectro esquizofrénico

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