Can schizophrenia begin after age 44?

Thirty-five patients who developed a delusional disorder after age 44 were studied to determine whether they had symptom profiles different from age-matched affectively ill patients and whether they were similar to patients described in the European literature as suffering late onset schizophrenia. Patients were predominantly women and most had auditory hallucinations. Two-thirds and first-rank symptoms of Schneider. DSM-III critera were retrospectively applied: 21 patients met all DSM-III criteria for schizophrenia except for the criterion requiring onset before age 45. Eleven of the patients met criteria for schizophreniform illness and three met criteria for paranoia. We suggest that a schizophrenia-like illness can begin after age 44 and that future versions of the Diagnostic and Statistical Manual contain a category for such patients.