Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T07:12:24.689Z Has data issue: false hasContentIssue false
  • English
  • Français

A Comparative Study of 470 Cases of Early-Onset and Late-Onset Schizophrenia

Published online by Cambridge University Press:  02 January 2018

Robert Howard ,
David Castle ,
Simon Wessely  and
Robin Murray
Robert Howard*
Affiliation:
Section of Old Age Psychiatry
David Castle
Affiliation:
Genetics Section, Institute of Psychiatry
Simon Wessely
Affiliation:
King's College Hospital and Institute of Psychiatry
Robin Murray
Affiliation:
King's College Hospital and Institute of Psychiatry
*
∗Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Abstract

The presence or absence of 22 schizophrenic symptoms was recorded with the age at onset of illness in 470 patients with non-affective, non-organic psychoses. Positive and negative formal thought disorder, affective symptoms, inappropriate affect, delusions of grandiosity or passivity, primary delusions other than delusional perception, and thought insertion and withdrawal were all more common in early-onset cases (age at onset 44 years or less; n = 336). Persecutory delusions with and without hallucinations, organised delusions, and third-person, running commentary and accusatory or abusive auditory hallucinations were all more common in late-onset cases (age at onset 45 years or more; n = 134). There was no difference between cases of early and late onset in the prevalence of delusions of reference, bizarre delusions, delusional perception, or lack of insight. We conclude that although there are clinical similarities between cases of schizophrenia with early and late onset, there are sufficient differences between them to suggest that they are not phenotypically homogeneous.

Type
Papers
Information
The British Journal of Psychiatry , Volume 163 , Issue 3 , September 1993 , pp. 352 - 357
Copyright
Copyright © Royal College of Psychiatrists, 1993 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington. DC: APA.Google Scholar
Bleuler, E. (1911) Dementia Praecox or the Croup of Schizophrenias (English edn). New York: International University Press.Google Scholar
Bleuler, M. (1943) Die spatschizophrenen Krankheitsbilder (The clinical picture in late schizophrenia). Fortschritte der Neurologie-Psychiatrie, 15, 259–290.Google Scholar
Brietner, J. C. S., Husain, M. M., Figiel, G. S., et al (1990) Cerebral white matter disease in late-onset paranoid psychosis. Biological Psychiatry, 28, 266–274.Google Scholar
Carpenter, W. T., Strauss, J. S. & Mulec, S. (1973) Are there pathogonomic symptoms in schizophrenia? Archives of General Psychiatry, 28, 847–852.Google Scholar
Castle, D. & Murray, R. (1991) The neurodevelopmental basis of sex differences in schizophrenia. Psychological Medicine, 21, 565–575.CrossRefGoogle ScholarPubMed
Castle, D. & Murray, R., Wesseley, S., Der, G., et al (1991) The incidence of operationally defined schizophrenia in Camberwell 1965–84. British Journal of Psychiatry, 159, 790–794.Google Scholar
Castle, D. & Murray, R. & Howard, R. (1992) What do we know about the aetiology of late-onset schizophrenia? European Psychiatry, 7, 99–108.Google Scholar
Castle, D. & Murray, R., Wessley, S. & Murray, R. (1993) Sex and schizophrenia: effects of diagnostic stringency and associations with premorbid variables. British Journal of Psychiatry, 162, 658–664.CrossRefGoogle ScholarPubMed
Fish, F. (1960) Senile schizophrenia. Journal of Mental Science, 106, 938–946.Google Scholar
Gold, D. G. (1984) Late age of onset of schizophrenia: present but unaccounted for. Comprehensive Psychiatry, 25, 225–237.CrossRefGoogle ScholarPubMed
Grahame, P. S. (1984) Schizophrenia in old age (late paraphrenia). British Journal of Psychiatry, 145, 493–495.Google Scholar
Harris, M. J. & Jeste, D. V. (1988) Late-onset schizophrenia: an overview. Schizophrenia Bulletin, 14, 39–45.Google Scholar
Herbert, M. E. & Jacobson, S. (1967) Late paraphrenia. British Journal of Psychiatry, 113, 461–469.Google Scholar
Holden, N. L. (1987) Late paraphrenia or the paraphrenias? A descriptive study with a 10-year follow-up. British Journal of Psychiatry, 150, 635–639.Google Scholar
Howard, R., Castle, D., Wessley, S., et al (1993) Early- and late-onset schizophrenia Getter). American Journal of Psychiatry, 150, 846.Google Scholar
Huber, G., Gross, G. & Schuttler, R. (1975) Spatschizophrenie. Archiv für Psychiatrie und Nervenkrankheiten, 221, 53–66.Google Scholar
Kay, D. W. K. (1972) Schizophrenia and schizophrenia-like states in the elderly. In Contemporary Psychiatry (eds Silverstone, T. & Barraclough, B.), pp. 18–24. London: Royal College of Psychiatrists.Google Scholar
Kay, D. W. K. & Roth, M. (1961) Environmental and hereditary factors in the schizophrenias of old age (late paraphrenia) and their bearing on the general problem of causation in schizophrenia. Journal of Mental Science, 107, 649–686.CrossRefGoogle ScholarPubMed
Kolle, K. (1931) Dir primare verucktheit (Primary madness or paranoia). Leipzig: Theime.Google Scholar
Kraepelin, E. (1904) Psychiatrie, ein Lehrbuch für Studierende und Aerzte (Psychiatry, a Textbook for Students and Practitioners) (7th edn). Leipzig: J. A. Barth.Google Scholar
Kraepelin, E. (1913) Psychiatrie, ein Lehrbuch für Studierende und Artze (Psychiatry, a Textbook for Students and Practitioners) (8th edn). Vol. 3. Leipzig: J. A. Barth.Google Scholar
Kraepelin, E. (1919) Dementia Praecox and Paraphrenia (trans. Barclay, R. M.). Edinburgh: Livingstone.Google Scholar
Lewine, R. R. J. (1988) Gender and schizophrenia. In Handbook of Schizophrenia, Vol. 3 (eds Tsuang, M. T. & Simpson, J. C.). Amsterdam: Elsevier.Google Scholar
McGuffin, P., Farmer, A. E. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764–770.Google Scholar
Mellor, C. S. (1970) First rank symptoms of schizophrenia. British Journal of Psychiatry, 117, 15–23.Google Scholar
Miller, B. E., Lesser, I. M., Boone, K., et al (1989) Brain white-matter lesions and psychosis. British Journal of Psychiatry, 155, 73–78.Google Scholar
Mueller, C. (1959) Ueber das Senium der Schizophrenen. Basel: Karger.Google Scholar
Murray, R. M., O'Callaghan, E., Castle, D. J., et al (1992) A neurodevelopmental approach to the classification of schizophrenia. Schizophrenia Bulletin, 18, 319–332.CrossRefGoogle Scholar
Naguib, M. & Levy, R. (1987) Late paraphrenia: neuropsychological impairment and structural abnormalities on computed tomography. International Journal of Geriatric Psychiatry, 2, 83–90.CrossRefGoogle Scholar
Pearlson, G. D., Kreger, L., Rabins, P. V., et al (1989) A chart review study of late-onset and early-onset schizophrenia. American Journal of Psychiatry, 146, 1568–1574.Google Scholar
Post, F. (1966) Persistent Persecutory States of the Elderly. Oxford: Pergamon.Google Scholar
Rabins, P. V., Pauker, S. & Thomas, J. (1984) Can schizophrenia begin after age 44? Comprehensive Psychiatry, 25, 290–293.Google Scholar
Roth, M. (1955) The natural history of mental disorder in old age. Journal of Mental Science, 101, 281–301.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Volavka, J. (1985) Later-onset schizophrenia: a review. Comprehensive Psychiatry, 26, 148–156.Google Scholar
Wing, J. & Hailey, A. M. (1972) Evaluating a community psychiatric service. London: Oxford University Press.Google Scholar
Wing, J. & Hailey, A. M., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.