Schizophrenia's late start.

Schizophrenia's late start

Schizophrenia, with its baffling mix of symptoms that include social withdrawal, inappropriate emotions and confused thoughts, often begins in adolescence or young adulthood. Claims that full-blown schizophrenia sometimes appears after age 45, and that this so-called "late-onset" form is a distinct subtype of the disorder, are controversial.

But a review of 25 studies of schizophrenia's course indicates nearly one-quarter of all cases do begin after age 40, and many of those individuals may surpass the age cut-off for late-onset schizophrenia, contends Dilip V. Jeste of the Veterans Administration Medical Center in San Diego.

In a study at his own facility, Jeste identified 12 women and eight men who first experienced schizophrenic symptoms in their 50s. At the time of the research, they had been diagnosed as schizophrenic for approximately six years.

The patients' schizophrenic symptoms generally were of moderate severity, Jeste says. Eighteen patients had been or were currently married, a clear sign that schizophrenia had not blotted out all social capacities. The patients typically described bizarre delusions that they were being persecuted by some external person or force, and a majority experienced frequent auditory hallucinations. Delusions and hallucinations eased substantially with about one-quarter the daily dose of antipsychotic medication typically used with younger schizophrenics, Jeste points out.

"It's not clear whether late-onset schizophrenia is a distinct diagnostic substype," he notes. Nevertheless, the emergence of schizophrenia after age 45 is probably not as rare as is often assumed, according to Jeste.