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  • Title: Schizophrenia with onset at the extremes of adult life.
    Author: Castle DJ, Wessely S, Howard R, Murray RM.
    Journal: Int J Geriatr Psychiatry; 1997 Jul; 12(7):712-7. PubMed ID: 9251932.
    Abstract:
    OBJECTIVE: To define the epidemiology, phenomenology, premorbid and risk factors in patients with the first manifestation of a schizophrenia-like illness after the age of 60 years, and compare them with patients with an onset before the age of 25 years. DESIGN/SETTING/SUBJECTS: All contacts for a non-affective psychotic illness across all ages of onset were ascertained through a psychiatric case register; patients were rediagnosed according to operationalized criteria for psychotic illness, and those with a very early and very late onset compared. MAIN OUTCOMES MEASURES: Phenomenological, premorbid and aetiological parameters were compared in the two groups, using risk ratios and 95% confidence intervals. RESULTS: Very late onset patients (N = 72) were, compared to their very early onset counterparts (N = 192), more likely to be female, have good premorbid functioning and development history, and to exhibit persecutory delusions and hallucinations; they were less likely to have negative schizophrenic symptoms, to have a positive family history of schizophrenia, or have suffered pregnancy or birth complications. CONCLUSIONS: The results highlight premorbid, aetiological and phenomenological differences between patients with the onset of a schizophrenia-like illness at the extremes of adult life, and suggest it is premature to consider the two groups to be merely different manifestations of the same illness.
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