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Is late‐onset schizophrenia a subtype of schizophrenia?

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Vahia, I. V., Palmer, B. W., Depp, C., Fellows, I., Golshan, S., Kraemer, H. C., Jeste, D. V.·2010·Acta Psychiatrica Scandinavica
DOI 10.1111/j.1600-0447.2010.01552.xPMC PMC3939834
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Abstract

Vahia IV, Palmer BW, Depp C, Fellows I, Golshan S, Kraemer HC, Jeste DV. Is late‐onset schizophrenia a subtype of schizophrenia? Objective: To determine whether late‐onset schizophrenia (LOS, onset after age 40) should be considered a distinct subtype of schizophrenia. Method: Participants included 359 normal comparison subjects (NCs) and 854 schizophrenia out‐patients age >40 (110 LOS, 744 early‐onset schizophrenia or EOS). Assessments included standardized measures of psychopathology, neurocognition, and functioning. Results: Early‐onset schizophrenia and LOS groups differed from NCs on all measures of psychopathology and functioning, and most cognitive tests. Early‐onset schizophrenia and LOS groups had similar education, severity of depressive, negative, and deficit symptoms, crystallized knowledge, and auditory working memory, but LOS patients included more women and married individuals, had less severe positive symptoms and general psychopathology, and better processing speed, abstraction, verbal memory, and everyday functioning, and were on lower antipsychotic doses. Most EOS–LOS differences remained significant after adjusting for age, gender, severity of negative or deficit symptoms, and duration of illness. Conclusion: Late‐onset schizophrenia should be considered a subtype of schizophrenia.

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  • Late-onset schizophrenia appeared to be as stable a diagnosis as early-onset schizophrenia; both diagnoses remained unchanged in up to 93% of cases in a follow-up, and only rarely were they reclassified as mood disorders.

    “Late‐onset schizophrenia appeared to be as stable a diagnosis as early‐onset schizophrenia; both diagnoses remained unchanged in up to 93% of cases in a follow‐up, and only rarely were they reclassified as mood disorders263, 264.”

    From Mental health care for older adults: recent advances and new directions in clinical practice and research (2022) · cites this paper as [264]

  • Sensory deficits, especially long-standing conductive deafness, are common in the late-onset form, but may primarily reflect the patients' reluctance to seek corrective measures or their inability to get correction of these deficits because of poor access to quality health care.

    “Sensory deficits, especially long‐standing conductive deafness, are common in the late‐onset form 264 , but may primarily reflect the patients' reluctance to seek corrective measures or their inability to get correction of these deficits because of poor access to quality health care.”

    From Mental health care for older adults: recent advances and new directions in clinical practice and research (2022) · cites this paper as [264]

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  1. [8]OXFORD UNIVERSITY PRESS Oxford English Dictionary Online Available at: http://www.oed.com 2008
  2. [75]WECHSLER D Wechsler Adult Intelligence Scale - Third Edition (WAIS-III) Adminstration and Scoring manual San Antonio, TX The Psychological Corporation 1997
  3. [84]SPITZER RL WILLIAMS JB GIBBON M FIRST MB Structured clinical interview for the DSM-III-R, Patient Edition/Non-patient Edition. (SCID-P/SCID-NP) Washington, DC American Psychiatric Association 1990
  4. [85]FIRST MB SPITZER RL GIBBON M WILLIAMS JBW Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition With Psychotic Screen (SCID-I/P W/PSY SCREEN) New York Biometrics Research, New York State Psychiatric Institute 2002

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Authors
Vahia, I. V., Palmer, B. W., Depp, C., Fellows, I., Golshan, S., Kraemer, H. C., & Jeste, D. V.
Affiliations
  • University of California San Diego (US)
  • Stanford Medicine (US)
Corresponding author
Jeste, D. V.
ORCID
Venue
Acta Psychiatrica Scandinavica
Publisher
Wiley
Published
2010-02-25
Volume
122
Issue
5
Pages
414-426
ISSN
  • 0001-690X (ISSN-L)
  • 1600-0447
DOI
10.1111/j.1600-0447.2010.01552.x
PMC
PMC3939834
OpenAlex
W1752961086
Cited by
119
References
95
Citations by year
2026: 2 · 2025: 2 · 2024: 10 · 2023: 7 · 2022: 9 · 2021: 8 · 2020: 7 · 2019: 10 · 2018: 12 · 2017: 8 · 2016: 4 · 2015: 7 · 2014: 4 · 2013: 10 · 2012: 13
FWCI
6.34
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Acta Psychiatrica Scandinavica (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University of California, San Diego
  • National Institute of Mental Health (P30MH080002, MH-43693, MH080002, MH019934, R01MH064722, MH 064722, T32MH019934)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
late-onset schizophrenia, early-onset schizophrenia, schizophrenia subtypes, schizophrenia diagnosis, neurocognitive function, functioning, psychopathology, negative symptoms, processing speed, auditory working memory, antipsychotic dosing, age of onset
MeSH terms
Activities of Daily Living, Adult, Age Factors, Aged, Analysis of Variance, Cognition, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, Sex Factors, Chi-Square Distribution, Linear Models, Age of Onset

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