TY - JOUR
T1 - Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis
T2 - An international consensus
AU - Howard, Robert
AU - Rabins, Peter V.
AU - Seeman, Mary V.
AU - Jeste, Dilip V.
PY - 2000/2
Y1 - 2000/2
N2 - Objective: Although schizophrenia is generally regarded as an illness with onset in late adolescence or early adult life, a sizeable minority of patients first become ill in middle or old age. Inconsistencies in diagnostic systems and nomenclature, coupled with a tendency among most schizophrenia researchers to ascribe late-onset psychoses to organic factors, have led to such cases occupying an ambiguous position in relation to schizophrenia. Through systematic review of the literature and publication of a consensus statement from an international group of experts in the field, this article aims to clarify the positions of lateonset schizophrenia and very-late-onset schizophrenia-like psychosis. Method: The authors conducted a MEDLINE literature review and developed a consensus statement summarizing the findings from 2 days of debate and discussion by members of the International Late-Onset Schizophrenia Group. Results: The group achieved consensus on diagnosis, nomenclature, treatment guidelines, and future research directions. Conclusions: In terms of epidemiology, symptom profile, and identified pathophysiologies, the diagnoses of late-onset schizophrenia (illness onset after 40 years of age) and very-late-onset schizophrenia-like psychosis (onset after 60 years) have face validity and clinical utility. General adoption of these categories will foster systematic investigation of such patients.
AB - Objective: Although schizophrenia is generally regarded as an illness with onset in late adolescence or early adult life, a sizeable minority of patients first become ill in middle or old age. Inconsistencies in diagnostic systems and nomenclature, coupled with a tendency among most schizophrenia researchers to ascribe late-onset psychoses to organic factors, have led to such cases occupying an ambiguous position in relation to schizophrenia. Through systematic review of the literature and publication of a consensus statement from an international group of experts in the field, this article aims to clarify the positions of lateonset schizophrenia and very-late-onset schizophrenia-like psychosis. Method: The authors conducted a MEDLINE literature review and developed a consensus statement summarizing the findings from 2 days of debate and discussion by members of the International Late-Onset Schizophrenia Group. Results: The group achieved consensus on diagnosis, nomenclature, treatment guidelines, and future research directions. Conclusions: In terms of epidemiology, symptom profile, and identified pathophysiologies, the diagnoses of late-onset schizophrenia (illness onset after 40 years of age) and very-late-onset schizophrenia-like psychosis (onset after 60 years) have face validity and clinical utility. General adoption of these categories will foster systematic investigation of such patients.
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U2 - 10.1176/appi.ajp.157.2.172
DO - 10.1176/appi.ajp.157.2.172
M3 - Article
C2 - 10671383
AN - SCOPUS:0033960480
SN - 0002-953X
VL - 157
SP - 172
EP - 178
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 2
ER -