Risk factors for the late‐onset psychoses: a systematic review of cohort studies

Brunelle, Sarah; Cole, Martín G.; Élie, Michel

doi:10.1002/gps.2702

Cited by 28 publications

(10 citation statements)

References 49 publications

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“…Although these have led to the identification of several potential risk factors, including sensory impairments, 15 social isolation, 16,17 premorbid schizotypal traits, 16 and traumatic life events, 18–21 results have not been consistently replicated. 22 Epidemiological investigation in large, population-based longitudinal studies is largely lacking, with limited exceptions. 10 Older people have consistently been omitted from studies that have elucidated a robust set of risk indicators for psychotic disorders at younger ages.…”

Section: Introductionmentioning

confidence: 99%

The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden

Stafford

Howard

Dalman

et al. 2018

Schizophrenia Bulletin

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Background There are limited data on the epidemiology of very late-onset schizophrenia-like psychosis (VLOSLP) and how this relates to potential risk factors including migration, sensory impairment, traumatic life events, and social isolation. Methods We followed up a cohort of 3 007 378 people living in Sweden, born 1920–1949, from their 60th birthday (earliest: January 15, 1980) until December 30 2011, emigration, death, or first recorded diagnosis of nonaffective psychosis. We examined VLOSLP incidence by age, sex, region of origin, income, partner or child death, birth period, and sensory impairments. Results We identified 14 977 cases and an overall incidence of 37.7 per 100 000 person-years at-risk (95% CI = 37.1–38.3), with evidence that rates increased more sharply with age for women (likelihood ratio test: χ2(6) = 31.56, P < .001). After adjustment for confounders, rates of VLOSLP were higher among migrants from Africa (hazard ratio [HR] = 2.0, 95% CI = 1.4–2.7), North America (HR = 1.4, 95% CI = 1.0–1.9, P = .04), Europe (HR = 1.3, 95% CI = 1.2–1.4), Russian-Baltic regions (HR = 1.6, 95% CI = 1.4–1.9), and Finland (HR = 1.6, 95% CI = 1.5–1.7). VLOSLP risk was highest for those in the lowest income quartile (HR = 3.1, 95% CI = 2.9–3.3). Rates were raised in those whose partner died 2 years before cohort exit (HR = 1.1, 95% CI = 1.0–1.3, P = .02) or whose child died in infancy (HR = 1.2, 95% CI = 1.0–1.4, P = .05), those without a partner (HR = 1.9, 95% CI = 1.8–1.9) or children (HR = 2.4, 95% CI = 2.3–2.5), and those whose child had a psychotic disorder (HR = 2.4, 95% CI = 2.2–2.6). Interpretation We identified a substantial burden of psychosis incidence in old age, with a higher preponderance in women and most migrant groups. Life course exposure to environmental factors including markers of deprivation, isolation, and adversity were associated with VLOSLP risk.

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Section: Introductionmentioning

confidence: 99%

The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden

Stafford

Howard

Dalman

et al. 2018

Schizophrenia Bulletin

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“…D'autre part, le Dr Amyot a publié plusieurs résumés, articles ou chapitres de livre sur la psychothérapie des personnes âgées (Amyot, 2003). Dre Brunelle s'est quant à elle intéressée aux facteurs de risque de la psychose d'apparition tardive (Brunelle et al, 2012) Les membres de l'équipe du PAP ont toujours offert une implication sur le plan universitaire, organisationnel et politique. Le Dr Amyot a été directeur du Département universitaire et aussi responsable de la santé mentale au Ministère de la Santé et des Services sociaux dans les années 1980.…”

Section: L'enseignement De La Gérontopsychiatrie à L'université De Mounclassified

L’éclosion de la gérontopsychiatrie à l’Université de Montréal, une histoire à découvrir

Paquette

Amyot²,

Létourneau

2015

smq

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La gérontopsychiatrie est une surspécialité de la psychiatrie qui s’intéresse à l’évaluation, au diagnostic et au traitement des troubles mentaux complexes chez les personnes âgées. Fait méconnu, son histoire encore jeune est fortement liée, au Québec, à celle du Département de psychiatrie de l’Université de Montréal (UdeM) et son réseau d’hôpitaux d’enseignement : dès la fin des années 1970, le premier service de gérontopsychiatrie a vu le jour à l’Institut universitaire en santé mentale de Montréal, et la première clinique externe au Pavillon Albert-Prévost. Le Centre hospitalier de l’Université de Montréal, l’Hôpital Maisonneuve-Rosemont et l’Institut universitaire de gériatrie de Montréal ont développé par la suite des services de gérontopsychiatrie à leur image. Le département de psychiatrie de l’UdeM est aussi le premier au Québec à offrir un programme de résidence en gérontopsychiatrie agréé par le Collège royal des médecins et chirurgiens du Canada, et ce depuis 2014. La gérontopsychiatrie est un domaine en plein essor, et les défis sont multiples dans le contexte démographique actuel. Pourtant, des obstacles majeurs freinent son développement sur le plan clinique, de l’enseignement et de la recherche, en particulier l’absence de postes spécifiques et protégés en gérontopsychiatrie. La restructuration majeure du réseau de la santé au Québec en 2015 est un autre point d’incertitude. Ce cinquantenaire du département de psychiatrie est une occasion de souligner l’apport majeur de l’UdeM au développement de la gérontopsychiatrie au Québec, et d’insister sur la spécificité des besoins des aînés en matière de soins et de services en santé mentale.

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“…Besides being affected by life-long chronic psychiatric disturbances, older people might run into new (or newly diagnosed) mental disorders. They include neurodegenerative disorders leading to dementias [4], late-onset psychoses [5], and 'common mental disorders' such as depressive, adjustment and anxiety disorders.…”

Section: Introductionmentioning

confidence: 99%

Late-Life Mental Health Disorders. Data from a Population-Based Study

Ar¹,

Morri²,

Gibiino³

et al. 2015

J Alzheimers Dis Parkinsonism

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Risk factors for the late‐onset psychoses: a systematic review of cohort studies

Cited by 28 publications

References 49 publications

The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden

The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden

L’éclosion de la gérontopsychiatrie à l’Université de Montréal, une histoire à découvrir

Late-Life Mental Health Disorders. Data from a Population-Based Study

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