Older people with schizophrenia: a community study in a rural catchment area

Abstract

Despite significant differences in presentation, elderly patients with schizophrenia and very late onset schizophrenia-like psychosis have much in common. Both groups are vulnerable with high levels of psychopathology, poor insight, sensory impairment and social isolation. The needs of older people with schizophrenia must be taken into account when services for older adults are planned.

Late-Onset Psychosis; Is It Real?

“…This might imply that the brains of men and women show sex-specific susceptibility of primary psychosis according to age. 34 This female dominance in the late-onset psychosis has been a consistent finding, 2,3,8,10,11,14,17,30,31,[39][40][41][42][43] and is not due to a potential social covariate like marital status, role-expectations, help-seeking behaviors and premorbid adjustment. 44 It is conceivable that estrogen is protective and its withdrawal in mid-life following menopause creates the milieu to develop late-onset psychosis.…”

“…The overall assessed severity of negative symptoms in patients with late-onset psychosis compared to old patients with earlyonset psychosis, 8,37 though other studies reported no significant difference. 10,46 Especially, when psychosis develops after the age of 60 years, formal thought disorder and negative symptoms are very rare.…”

“…5,6 Considering the relative absence of thought disorganization, catatonia and negative symptoms in patients with late-onset psychosis, 8,[11][12][13][14][15] differentiating schizophrenia from delusional disorder is rather arbitrary. The clinical usefulness of this differentiation may be questioned.…”

“…The lack of nosocological clarity has spurred recent studies to adopt a combined diagnosis, such as schizophrenia with delusional disorder, 8,9 schizophreniform disorder, 9 schizoaffective disorder 9,10 and nonspecific psychotic disorder 9 under the umbrella terms of late-onset schizophrenia and/or very-lateonset schizophrenia-like psychosis.…”

“…Proposed diagnostic criteria had been not clearly outlined, which has led to ongoing inconsistency and confusion about how the criteria should be applied clinically and in research studies. [8][9][10] Moreover, whether distinguishing schizo-…”