Clinical differences between late-onset and early-onset chronically hospitalized elderly schizophrenic patients in Taiwan

Int J Geriatr Psychiatry. 2009 Oct;24(10):1166-72. doi: 10.1002/gps.2241.

Abstract

Objectives: To examine the clinical differences between late-onset schizophrenia (LOS) and early-onset schizophrenia (EOS) in Taiwanese elderly chronic hospitalized schizophrenic patients.

Methods: By using a cross-sectional study method, we investigated all the hospitalized elderly schizophrenic patients in a general hospital's psychiatric ward during July-September 2007. All the subjects matched DSM-IV-TR diagnostic criteria and were aged 60 years or above. A total of 52 subjects were enrolled (LOS = 23, EOS = 29). Demographic data, illness history, and antipsychotic treatment record were documented; the positive and negative syndrome scale (PANSS), Center for Epidemiological Studies Depression scale (CES-D), mini-mental status examination (MMSE), activities of daily living rating scale for psychiatric patients (ADLRS), community self-sufficiency test (CST), clinical global impression (CGI), and general assessment of functioning scale (GAF) were administered.

Results: In our samples, a lower educational level was found to be more common in late-onset patients. In LOS, there was no significant increase in the severity of PANSS psychopathology except for greater thought disorder symptoms. Both LOS and EOS patients had similar cognitive and functioning impairment with poor global outcomes. There was a trend of low antipsychotic drug use in LOS.

Conclusions: In Taiwan, elderly chronic inpatients LOS had greater thought disorders compared to findings in Western studies. Further large-scale longitudinal studies are needed to understand the factors related to these findings.

MeSH terms

  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / therapeutic use
  • Chronic Disease
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy
  • Schizophrenia / epidemiology*
  • Taiwan / epidemiology

Substances

  • Antipsychotic Agents