Skip to main content
×
Home
    • Aa
    • Aa

Dimensions of positive symptoms in late versus early onset psychosis

  • Oliver Mason (a1) (a2), Joshua Stott (a1) and Ruth Sweeting (a1)
Abstract
ABSTRACT

Background: Casenote studies have characterized late onset schizophrenia (LOS) and related psychoses as somewhat different symptomatically from patients with an early onset schizophrenia (EOS). This study examined a range of phenomenological aspects of delusions and hallucinations as well as traditional symptom measures in both groups.

Methods: 34 LOS and 235 EOS completed the Positive and Negative Syndrome Scale, the Psychotic Symptom Rating Scales, and the Beck Depression and Anxiety inventories. Subgroups experiencing delusions were compared matching for chronological age and gender, and also when matched for chronicity and gender.

Results: Delusions were very common at over 80% in both groups. LOS participants with delusions exhibited greater suspiciousness/paranoia, greater belief-conviction, and reduced insight when compared with the EOS group. These findings remained when matching for chronicity of illness, but disappeared when matching for chronological age. Hallucinations were surprisingly rarer in LOS (35%) than EOS (57%), with half the LOS group reporting whispers rather than clearly audible sounds. In general, anxiety, depression, and distress were as marked in LOS and EOS.

Conclusions: Similarities between EOS and LOS far outweighed the differences across a range of symptoms and measures. Greater delusional conviction, paranoia, and poorer insight in LOS were associated with the later age of onset rather than relating to chronicity of illness. As belief-conviction in LOS was not associated with increased grandiosity, disorientation, or unusualness of thought content, as it was in EOS, delusional conviction may be determined somewhat differently later in life.

Copyright
Corresponding author
Correspondence should be addressed to: Dr. Oliver Mason, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 6BT, UK. Phone: +44-0207-679-8230; Fax: +44-0207-916-1989. Email: o.mason@ucl.ac.uk.
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

O. P. Almeida , R. J. Howard , R. Levy and A. S. David (1995). Psychotic states arising in late-life (late paraphrenia): the role of risk-factors. British Journal of Psychiatry, 166, 215228.

O. P. Almeida , R. Levy , R. J. Howard and A. S. David (1996). Insight and paranoid disorders in late life (late paraphrenia). International Journal of Geriatric Psychiatry, 11, 653658.

A. Beck , N. Epstein , G. Brown and R. Steer (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893897.

D. J. Castle , S. Wessely , R. Howard and R. M. Murray (1997). Schizophrenia with onset at the extremes of adult life. International Journal of Geriatric Psychiatry, 12, 712717.

C. I. Cohen , I. Vahia , P. Reyes , S. Diwan , A. O. Bankole and N. Palekar (2008). Schizophrenia in later life: clinical symptoms and social well-being. Psychiatric Services, 59, 232234.

R. Drake , G. Haddock , N. Tarrier , R. Bentall and S. Lewis (2007). The Psychotic Symptom Rating Scales (PSYRATS): their usefulness and properties in first episode psychosis. Schizophrenia Research, 89, 119122.

M. F. Folstein , S. E. Folstein and P. R. McHugh (1975). Mini-mental state: practical method for grading cognitive state of patients for clinician. Journal of Psychiatric Research, 12, 189198.

G. Haddock , J. McCarron , N. Tarrier and E. B. Faragher (1999). Scales to measure dimensions of hallucinations and delusions: the Psychotic Symptom Rating Scales (PSYRATS). Psychological Medicine, 29, 879889.

H. Häfner , M. Hambrecht , W. Loffler , P. Munk-Jorgensen and A. Riecher-Rossler (1998). Is schizophrenia a disorder of all ages? A comparison of first episodes and early course across the life-cycle. Psychological Medicine, 28, 351365.

A. Hassett (1997). The case for a psychological perspective on late-onset psychosis. Australian and New Zealand Journal of Psychiatry, 31, 6875.

R. Howard , D. Castle , S. Wessely and R. Murray (1993a). A comparative study of 470 cases of early-onset and late-onset schizophrenia. British Journal of Psychiatry, 163, 352357.

R. Howard , O. Almeida and R. Levy (1993b). Schizophrenic symptoms in late paraphrenia. Psychopathology, 26, 95101.

R. Howard , P. V. Rabins , M. V. Seeman and D. V. Jeste (2000). Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: an international consensus. American Journal of Psychiatry, 157, 172178.

C. Huang and Y. L. Zhang (2009). Clinical differences between late-onset and early-onset chronically hospitalized elderly schizophrenic patients in Taiwan. International Journal of Geriatric Psychiatry, 24, 11661172.

M. McPherson , L. Smith-Lovin and M. Brashears (2006). Social isolation in America: changes in core discussion networks over two decades. American Sociological Review, 71, 353375.

C. Mayer , G. Kelterborn and D. Naber (1993). Age of onset in schizophrenia: relations to psychopathology and gender. British Journal of Psychiatry, 162, 665671.

P. Mitter , S. Reeves , F. Romero-Rubiales , P. Bell , R. Stewart and R. Howard (2005). Migrant status, age, gender and social isolation in very late-onset schizophrenia-like psychosis. International Journal of Geriatric Psychiatry, 20, 10461051.

R. Moore , N. Blackwood , R. Corcoran , G. Rowse , P. Kinderman and R. Bentall (2006). Misunderstanding the intentions of others: an exploratory study of the cognitive etiology of persecutory delusions in very late-onset schizophrenia-like psychosis. American Journal of Geriatric Psychiatry, 14, 410418.

S. Prager and D. V. Jeste (1993). Sensory impairment in late-life schizophrenia. Schizophrenia Bulletin, 19, 755772.

T. Sato , R. Bottlender , A. Schröter and H. J. Möller (2004). Psychopathology of early-onset versus late-onset schizophrenia revisited: an observation of 473 neuroleptic-naive patients before and after first-admission treatments. Schizophrenia Research, 67, 175183.

I. V. Vahia , B. W. Palmer , C. Depp , I. Fellows , S. Golshan and H. C. Kraemer (2010). Is late-onset schizophrenia a subtype of schizophrenia? Acta Psychiatrica Scandinavica, 122, 414426.

J. Van Os , R. Howard , N. Takei and R. Murray (1995). Increasing age is a risk factor for psychosis in the elderly Social Psychiatry and Psychiatric Epidemiology, 30, 161164.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: