Plenary Session 2: Late onset psychosis / schizophrenia

Abstract

Overview: This presentation will focus on late-onset schizophrenia (LOS) as well as ageing of persons with early-onset schizophrenia (EOS). 20% of middle-aged and older patients with schizophrenia have onset of illness after age 40. LOS is characterized by female preponderance, better premorbid functioning, fewer positive symptoms, and less cognitive impairment than EOS. EOS presents a paradox of aging – i.e., there is accelerated physical aging with multimorbidity and elevated mortality, while the mental well-being tends to improve with age. Adverse social determinants of health such as childhood traumas, social isolation, discrimination, and food insecurity worsen health. On the other hand, family and social support and access to necessary healthcare enhance the likelihood of sustained remission and recovery. Antipsychotics tend to be effective at doses lower than those in young adults, though the risk of side effects is higher. Psychosocial interventions like cognitive behavior therapy and social skills training are useful. It is important to employ the principles of Positive Psychiatry including promotion of resilience, social connections, optimism, and healthy lifestyle in people with schizophrenia