Late‐onset and nonlate‐onset schizophrenia: A comparison of clinical characteristics in a multicenter study

Abstract

Objectives Data are scarce regarding the potential clinical differences between non‐late onset schizophrenia (NLOS, i.e., disorder occurring before 40 years of age), late‐onset schizophrenia (LOS, occurring between ages 40 and 60 years) and very‐late‐onset schizophrenia‐like psychosis (VLOSLP, occurring after 60 years of age). Furthermore, previous research compared LOS patients with non‐age matched NLOS patients. In this study, we sought to examine potential clinical differences between patients of similar age with LOS and NLOS. Methods/Design This is a cross‐sectional multicentre study that recruited in‐ and outpatients older adults (aged ≥55 years) with an ICD‐10 diagnosis of schizophrenia or schizoaffective disorder with NLOS and LOS. Sociodemographic and clinical characteristics, comorbidity, psychotropic medications, quality of life, functioning, and mental health care utilization were drawn for comparison. Results Two hundred seventy‐two participants (79.8%) had NLOS, 61 (17.9%) LOS, and 8 (2.3%) VLOSLP. LOS was significantly and independently associated with greater severity of emotional withdrawal and lower severity of depression (all p < 0.05). However, the magnitude of these associations was modest, with significant adjusted odds ratios ranging from 0.71 to 1.24, and there were no significant between‐group differences in other characteristics. Conclusion In an age‐matched multicenter sample of elderly patients with schizophrenia, older adults with LOS were largely similar to older adults with NLOS in terms of clinical characteristics. The few differences observed may be at least partially related to symptom fluctuation with time. Implications of these findings for pharmacological and nonpharmacological management is yet to be determined.

Metabolic syndrome and risk of death in older adults with major psychiatric disorders: Results from a 5‐year prospective multicenter study

“…Longitudinal data were drawn from the CSA study, a cohort of 634 older people, aged 57–92 years (mean age = 67.9 years, SD = 7.2) with an ICD‐10 (International Classification of Diseases, Tenth edition) diagnosis of schizophrenia ( n = 353), bipolar disorder ( n = 139) or major depressive disorder ( n = 142). A more detailed description of the study methodology can be found elsewhere 1–9 . Participants were recruited between February 2010 and June 2013 from 63 French state hospital psychiatric departments, each of them covering one mutually independent catchment area 7,10–12 .…”

“…A more detailed description of the study methodology can be found elsewhere 1–9 . Participants were recruited between February 2010 and June 2013 from 63 French state hospital psychiatric departments, each of them covering one mutually independent catchment area 7,10–12 . Exclusion criteria included having limited French proficiency (due to the need for verbal communication during face‐to‐face interviews with the treating psychiatrist), not being affiliated to the social security system, meeting ICD‐10 criteria for any pervasive developmental disorder or major neurocognitive disorder, having any neurological disorder affecting the central nervous system or any serious, life threatening medical or surgical condition that requires immediate treatment.…”

“…A more detailed description of the study methodology can be found elsewhere. [1][2][3][4][5][6][7][8][9] Participants were recruited between February 2010 and June 2013 from 63 French state hospital psychiatric departments, each of them covering one mutually independent catchment area. 7,[10][11][12]…”

“…2 In fact, studies in adult psychiatric patients consistently highlight premature mortality, increased prevalence of cardiovascular diseases and their close association with metabolic syndrome. [2][3][4][5][6][7] However, in older psychiatric patients, only one study explored the relation between metabolic syndrome and mortality and its results were not in line with those of studies of younger adults with psychiatric disorders. 8 The discrepancy in findings related to metabolic syndrome and mortality between younger and older adults were initially noted in general population samples.…”

“…For the aforementioned disorders, life expectancy was reduced by 7–20 years 2 . In fact, studies in adult psychiatric patients consistently highlight premature mortality, increased prevalence of cardiovascular diseases and their close association with metabolic syndrome 2–7 . However, in older psychiatric patients, only one study explored the relation between metabolic syndrome and mortality and its results were not in line with those of studies of younger adults with psychiatric disorders 8 …”