Nondementia nonpraecox dementia praecox? Late-onset schizophrenia.
Schizophrenia has traditionally been viewed as a psychotic disorder with onset in adolescence or early adulthood and a deteriorating course. Over the past decade, the authors have been studying patients meeting DSM-III-R as well as specified research criteria for late-onset schizophrenia (onset after age 45) and several comparison groups with psychiatric, neurologic, neuropsychologic, brain-imaging, psychophysiological, and psychosocial assessments. Results to date suggest a number of similarities and differences between late-onset schizophrenia and comparison groups of other older patients with psychoses (including earlier-onset schizophrenia). Later-onset schizophrenia is probably a neurobiologically distinct subtype of schizophrenia. Differential involvement of cortico-striato-pallido-thalamic circuitry may explain differences in age at onset. The authors propose a new conceptual model for level of functioning at different stages of life in late-onset schizophrenia.
Jeste
D V
DV
Department of Psychiatry, University of California, San Diego, USA. dilipvjeste@gp-post.ucsd.edu
Symonds
L L
LL
Harris
M J
MJ
Paulsen
J S
JS
Palmer
B W
BW
Heaton
R K
RK
D000328:Adult; D000368:Aged; D000375:Aging; D002540:Cerebral Cortex / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D009626:Terminology as Topic