Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-28T03:56:05.439Z Has data issue: false hasContentIssue false

Age of Onset in Schizophrenia: Relations to Psychopathology and Gender

Published online by Cambridge University Press:  02 January 2018

C. Mayer
Affiliation:
Nervenklinik der Universität München, Psychiatrische Klink und Poliklinik, Nußbaumstraße 7, 8000 München 2, Germany
G. Kelterborn
Affiliation:
Nervenklinik der Universität München, Psychiatrische Klink und Poliklinik, Nußbaumstraße 7, 8000 München 2, Germany
D. Naber*
Affiliation:
Nervenklinik der Universität München, Psychiatrische Klink und Poliklinik, Nußbaumstraße 7, 8000 München 2, Germany
*
Correspondence

Abstract

This retrospective study evaluated differences between patients with first manifestation of schizophrenic psychosis (ICD 295) or paranoid syndrome (ICD 297) between the ages of 18 and 23 or 40 and 63 years. Gender-specific variations in psychopathology were also examined. The numerous analyses of variance gave few significant differences. Patients with a late onset of the disease scored higher on depressive and autonomic syndrome scales at admission, whereas patients with an early onset showed more psychosocial impairment at discharge and their stay in hospital was longer. Among schizophrenic patients only (ICD 297 excluded), only the higher score for autonomic syndrome of the older patients at admission was confirmed. Men were more apathetic at admission and discharge than were women. Excluding patients with a paranoid syndrome, these differences were again significant. Moreover, schizophrenic men had higher depressive and psycho-organic syndrome scores at discharge. The demonstration of only marginal differences between early- and late-onset schizophrenia does not support the assumption that age of onset markedly influences psychopathology.

Type
Research Article
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

Al-Issa, I. (1982) Sex differences in psychopathology. In Sex and Psychopathology (ed. Al-Issa, I.). New York: Academic Press.Google Scholar
AMDP (1981) Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie (4th edn). Berlin: Springer.Google Scholar
American Psychiatric Association (1980) The Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) The Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Andreasen, N. C., Flaum, M., Sayze, V. W., et al (1980) Positive and negative symptoms in schizophrenia. A critical reappraisal. Archives of General Psychiatry, 47, 615621.Google Scholar
Angermeyer, M. C. & Kühn, L. (1988) Gender differences in age at onset of schizophrenia: an overview. European Archives of Psychiatry and Neurological Sciences, 237, 351364.Google Scholar
Angst, J., Baastrup, P., Grof, P., et al (1973) Statistische Aspekte des Beginns und Verlaufs schizophrener Psychosen, In Verlauf und Ausgang schizophrener Erkrankungen. 2. Weißenauer Schizophrenie Symposium (ed. Huber, G.). Stuttgart: Schattauer.Google Scholar
Baron, M., Gruen, R., Asnis, L., et al (1983) Age-of-onset in schizophrenia and schizotypical disorders. Neuropsychology, 10, 199204.Google ScholarPubMed
Birkett, D. P. (1983) Differential diagnosis in the elderly Getter). American Journal of Psychiatry, 140, 134.Google Scholar
Bland, R. C., Parker, J. H. & Orn, H. (1976) Prognosis in schizophrenia. A ten-year follow up of first admissions. Archives of General Psychiatry, 33, 949954.Google Scholar
Bleuler, E. (1911) Dementia praecox order die Gruppe der Schizophrenien. In Handbuch der Psychiatrie, IV Abt, 1. Hälfte. Leipzig: Deutike.Google Scholar
Bleuler, M. (1943) Die spatschizophrenen Krankheitsbilder. Fortschritte in der Neurologie und Psychiatrie, 15, 259290.Google Scholar
Bleuler, M. (1968) A 23-year longitudinal study of 208 schizophrenics and impressions in regard to the nature of schizophrenia. In The Transmission of Schizophrenia (eds Rosenthal, D. & Kety, S. S.). Oxford: Pergamon Press.Google Scholar
Breitner, J. C., Husain, M. M., Figiel, G. S., et al (1990) Cerebral white matter disease in late-onset paranoid psychosis. Biological Psychiatry, 28, 266274.Google Scholar
Castle, D. J. & Murray, R. M. (1991) The neurodevelopmental basis of sex differences in schizophrenia. Psychological Medicine, 21, 565575.Google Scholar
Ciompi, L. & Müller, C. (1976) Lebensweg und Alter der Schizophrenen. Berlin: Springer.CrossRefGoogle Scholar
Dohrenwend, B. S. A Dohrenwend, B. P. (1976) Sex differences and psychiatric disorders. American Journal of Sociology, 81, 14471454.Google Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. L., et al (1976) The global assessment scale (GAS). A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766771.CrossRefGoogle ScholarPubMed
Essa, M. (1982) Late-onset schizophrenia. American Journal of Psychiatry, 139, 1528.Google Scholar
Fähndrich, E. & Richter, S. (1987) Zum Verlauf schizophrener Ersterkrankungen. Nervenarzt, 67, 705711.Google Scholar
Fish, F. (1960) Senile schizophrenia. Journal of Mental Science, 106, 938946.Google Scholar
Fisman, M. (1983) Differential diagnosis in the elderly - Dr Fisman replies (letter). American Journal of Psychiatry, 140, 134135.Google Scholar
Gabriel, E. (1974) Über den Einfluss psychoorganischer Beeinträchtigung im Alter auf den Verlauf sogenannter Spätschizophrenien. Psychiatria Clinica, 7, 358364.Google Scholar
Gabriel, E. (1978) Die langfristige Entwicklung von Spätschizophrenien. Basel: S. Karger.Google Scholar
Gebhardt, R., Pietzcker, A., Strauss, A., et al (1983) Skalenbildung im AMDP-System. Archiv für Psychiatrie und Nervenkrankheiten, 233, 223245.Google Scholar
Gold, D. D. Jr (1984) Late age of onset schizophrenia: present but unaccounted for. Comprehensive Psychiatry, 25, 225237.Google Scholar
Goldstein, J. M. & Link, B. G. (1988) Gender and expression of schizophrenia. Journal of Psychiatric Research, 22, 141155.Google Scholar
Häfner, H., Riecher, A., Maurer, K. et al. (1989) How does gender influence age at first hospitalization for schizophrenia? A transnational case register study. Psychological Medicine, 19, 903918.CrossRefGoogle ScholarPubMed
Häfner, H., Riecher, A., Maurer, K., Behrens, S., De Vry, J., et al (1991a) Oestradiol enhances the vulnerability threshold for schizophrenia in women by an early effect on dopaminergic neurotransmission. European Archives of Psychiatry and Clinical Neurosciences, 241, 6568.Google Scholar
Häfner, H., Riecher, A., Maurer, K., Behrens, S., De Vry, J., et al (1991b) Warum erkranken Frauen später an Schizophrenie? Erhöhung der Vulnerabilitätsschwelle durch Östrogen. Nervenheilkunde, 10, 154163.Google Scholar
Hamilton, M. (1978) Paranoid states. British Journal of Hospital Medicine, 20, 545548.Google Scholar
Harris, M. J., Cullum, C. M. & Jeste, D. V. (1988) Clinical presentation of late-onset schizophrenia. Journal of Clinical Psychiatry, 49, 356360.Google Scholar
Harris, M. J., Cullum, C. M. & Jeste, D. V. (1988) Late-onset schizophrenia: an overview. Schizophrenia Bulletin, 14, 3955.CrossRefGoogle ScholarPubMed
Herbert, M. E. & Jacobson, S. (1967) Late paraphrenia. British Journal of Psychiatry, 113, 461469.Google Scholar
Huber, G., Gross, G. & Schüttler, R. (1975) Spätschizophrenie. Archiv für Psychiatrie und Nervenkrankenheiten, 221, 5356.Google Scholar
Janzarik, W. (1975) Zur Problematik schizophrener Psychosen des höheren Le-bensalters. Nervenarzt, 28, 535542.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, 649686.Google Scholar
Klages, W. (1961) Die Spatschizophrenie. Stuttgart: Enke.Google Scholar
Kraepelin, E. (1904) Psychiatrie: ein Lehrbuch für Studierende und Ärzte (7. Auflage). Leipzig: J. A. Barth.Google Scholar
Kraepelin, E. (1912) Über paranoide Erkrankungen. Zeitschrift für die gesamte Neurologie und Psychiatrie, 11, 617638.Google Scholar
Kraepelin, E. (1926) Psychiatrie: ein Lehrbuch für Studierende und Ärzte (9. Auflage). Leipzig: J. A. Barth.Google Scholar
Leonhard, K. (1980) Aufteilung der endogenen Psychosen und ihre differenzierte Ätiologie (5. Auflage). Berlin: AkademieVerlag.Google Scholar
Leuchter, A. & Spar, J. (1985) The late-onset psychoses. Journal of Nervous and Mental Disease, 173, 4.Google Scholar
Lewine, R. R. J. (1981) Sex differences in schizophrenia: timing or subtypes? Psychological Bulletin, 90, 432444.Google Scholar
Loranger, A. W. (1984) Sex differences in age of symptom onset and first hospitalisation in schizophrenia. Archives of General Psychiatry, 41, 157161.Google Scholar
Ludewig, K. (1984) Zur Frage des Zusammenhangs zwischen Devianz und Geschlecht bei psychiatrischen Patienten. Zeitschrift für Klinische Psychologie, 13, 221229.Google Scholar
Markush, R. E. & Favero, R. V. (1974) Epidemiological assessment of stressful life events, depressed mood, and psychophysiological symptoms - a preliminary report. In Stressful Life Events: Their Nature and Effects (ed. Dohren wend, B. P.). New York: Wiley.Google Scholar
Marneros, A. & Deister, A. (1984) The psychopathology of “late schizophrenia”. Psychopathology, 17, 264274.Google Scholar
Mayer, W. (1921) Über paraphrene Psychosen. Zeitschrift für die gesamte Neurologie und Psychiatrie, 71, 187206.CrossRefGoogle Scholar
Miller, B. L., Benson, F. & Cummings, J. L. (1986) Late-life paraphrenia: an organic delusional syndrome. Journal of Clinical Psychiatry, 47, 204207.Google Scholar
Miller, B. L., Benson, F. & Cummings, J. L. & Lesser, I. M. (1988) Late-life psychosis and modern neuroimaging. Psychiatric Clinics of North America, 11, 3346.CrossRefGoogle ScholarPubMed
Möller, H. J. & von Zerssen, D. (1985) Psychopathometrische Untersuchung zur prognostischen Bedeutung des psychopathologischen Befundes und der prämorbiden Persönlichkeit für den Entlassungszustand neuroleptisch behandelter Patienten mit schizophrenen Psychosen. Nervenarzt, 56, 498505.Google Scholar
Munro, A. & Pollock, B. G. (1981) Monosymptomatic psychoses with progress to schizophrenia. Journal of Clinical Psychiatry, 42, 474476.Google Scholar
Nadsharow, R. A. & Sternberg, E. J. (1970) Die Bedeutung der Berücksichtigung des Altersfaktors für die psychopathologische, klinische und nosologische Forschung in der Psychiatrie. Schweizer Archiv für Neurologie, Neurologie und Psychiatrie, 106, 159179.Google Scholar
Naguib, M. & Levy, R. (1987) Late paraphrenia: neuropsychological impairment and structural brain abnormalities on computed tomography. International Journal of Geriatric Psychiatry, 2, 8390.Google Scholar
Nyman, A. K. (1978) Non-regressive schizophrenia: clinical course and outcome. Acta Psychiatrica Scandinavica (suppl. 272).Google 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, 15681574.Google Scholar
Post, F. (1966) Persistent Persecutory States of the Elderly. London: Pergamon Press.Google Scholar
Post, F. (1985) Paranoid and schizophrenic disorders among the aging. In Handbook of Clinical Gerontology (chapter 4). Oxford: Pergamon Press.Google Scholar
Rabins, P., Pauker, S. & Thomas, J. (1984) Can schizophrenia begin after age 44? Comprehensive Psychiatry, 25, 290293.Google Scholar
Rabins, P., Pauker, S. & Thomas, J., Pearlson, G., Jayaram, G., et al (1987) Increased ventricle-to-brain ratio in late-onset schizophrenia. American Journal of Psychiatry, 144, 12161218.Google Scholar
Roth, M. (1955) The natural history of mental disorder in old age. Journal of Mental Science, 101, 281293.Google Scholar
Seeman, M. V. (1981) Gender and the onset of schizophrenia: neurohumoral influences. Psychiatric Journal of the University of Ottawa, 6, 136138.Google Scholar
Shmaonova, L. M. & Liberman, I. U. I. (1980) Results from an epidemiological study on childhood schizophrenia. Zhumal Nevropatologii I Psikhiatrii, 64, 12241233.Google Scholar
Sternberg, E. & Konzewoi, V. (1978) Über besondere Erscheinungsformen der Schizophrenie im späten Lebensalter. Psychiatria Clinica, 11, 100110.Google Scholar
Tanna, V. L. (1974) Paranoid states: a selected review. Comprehensive Psychiatry, 15, 453470.Google Scholar
Volavka, J. (1985) Late onset schizophrenia: a review. Comprehensive Psychiatry, 26, 148156.Google Scholar
Walker, E., Bettes, B. A., Kain, E. L. et al. (1985) Relationship of gender and marital status with symptomatology in psychotic patients. Journal of Abnormal Psychology, 94, 4250.Google Scholar
Watt, J. A., Hall, D. J., Olley, P. C., et al (1980) Paranoid states of middle life. Familial occurrence and relationship to schizophrenia. Acta Psychiatrica Scandinavica, 61, 413426.Google Scholar
Westermeyer, J. F. & Harrow, M. (1984) Prognosis and outcome using broad (DSM-II) and narrow (DSM-III) concepts of schizophrenia. Schizophrenia Bulletin, 10, 624637.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.