Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: An international consensus

Robert Howard, Peter V. Rabins, Mary V. Seeman, Dilip V. Jeste

Research output: Contribution to journalArticlepeer-review

390 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)172-178
Number of pages7
JournalAmerican Journal of Psychiatry
Issue number2
StatePublished - Feb 1 2000
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health


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