- 153 Downloads
The onset of schizophrenia for the first time in late life has been considered rare, and the nosology of the late-onset functional psychoses remains contentious. However, it is clear that a significant proportion of individuals with a diagnosis of schizophrenia do have the first onset of the illness in late and very late life. The clinical presentation of such patients shows some differences from patients with early-onset disease, particularly in having a lower prevalence of premorbid dysfunction, negative symptoms and formal thought disorder. The longitudinal course is variable, possibly a reflection of aetiological heterogeneity. Atypical antipsychotic agents would appear to have significant benefits in the treatment of this group of patients, given the particular vulnerability of the elderly to extrapyramidal adverse effects, notably tardive dyskinesia.
KeywordsSchizophrenia Adis International Limited Clozapine Psychotic Symptom Tardive Dyskinesia
Unable to display preview. Download preview PDF.
- 2.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington, DC: American Psychiatric Press, 1987Google Scholar
- 4.World Health Organization (WHO). International classification of diseases. 9th ed. Geneva: WHO, 1978Google Scholar
- 5.Keith SJ, Regier DA, Rae DS. Schizophrenic disorders. In: Robins LN, Regier DA, editors. Psychiatric disorders in America. New York: Free Press, 1991Google Scholar
- 7.Christenson R, Blazer D. Epidemiology of persecutory ideation in an elderly population in the community. Am J Psychiatry 1984; 9(141): 1088–91Google Scholar
- 11.Parsons PL. Mental health of Swansea’s old folk. Br J Prev Soc Med 1964; 19: 43–7Google Scholar
- 13.Castle DJ. Gender and age at onset in schizophrenia. In: Howard R, Rabins P, editors. Late life schizophrenia: an international perspective. In pressGoogle Scholar
- 20.Castle DJ, Howard R. What do we know about the aetiology of late-onset schizophrenia? Eur Psychiatry 1992; 7: 99–108Google Scholar
- 30.Sciolla A, Jeste DV. Use of antipsychotics in the elderly. Int J Psychiatry Clin Pract 1998; 2Suppl. 1: S27–34Google Scholar
- 36.Salzman C, Vaccaro B, Lieff J, et al. Clozapine in older patients with psychosis and behavioural disruption. Am J Geriatr Psychiatry 1995; 3: 26–33Google Scholar
- 41.Leucht S, Pitshel-Walz G, Abraham D, et al. Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone and sertindole compared to conventional antipsychotics and placebo: a meta-analysis of randomised controlled trials. Schizophr Res 1999; 4; 35: 51–68CrossRefGoogle Scholar