Developmental Profiles: Early-Onset Compared to Late-Onset Schizophrenia and Affective Disorders

Summary

We investigated the developmental profiles of 36 schizophrenics and 14 patients with early-onset (under age 18) affective disorders and compared them to those of 22 schizophrenics and 31 patients with late-onset (35 years old or more but under age 50) affective disorders. These 103 patients were selected, based on age of onset, from 160 schizophrenic and 117 affective patients admitted to Nagasaki University Hospital between 1986 and 1990 who met Diagnostic and Statistical Manual of Mental Disorders (DSM-III or DSM-III-Revised) criteria. Developmental profiles were delineated by four general factors consisting of nine items that were surveyed in the patients’ clinical records: (1) genetic vulnerability (psychiatric illness in first-degree relatives); (2) physical and environmental risk factors (perinatal complications and the loss of either or both parents before age 15); (3) premorbid physical and behavioral problems (delay in motor and speech development, abnormal preferences, physical illness at less than age 18, maladaptation to school, low scholastic achievement); (4) precipitating factors (life events during the year before onset). The patients were classified on the basis of the characteristics of their develop mental profiles. A considerable number in both early-onset groups had genetic vulnerabilities, physical risk factors, and premorbid physical and behavioral problems, although circumstances varied between the groups. Moreover, a considerable number in both late-onset groups had experienced life events during the year before onset that were considered possible precipitating factors. A large number of the late-onset affective disorder patients had genetic vulnerability, whereas a high proportion of the late-onset schizophrenia patients had experienced environmental risk factors. Thus the four groups were fairly well differentiated by their developmental profiles.