Maglione Jeanne E, Thomas Scot E, Jeste Dilip V
Department of Psychiatry, University of California, San Diego, La Jolla, California, USA.
Curr Opin Psychiatry. 2014 May;27(3):173-8. doi: 10.1097/YCO.0000000000000049.
To review recent literature about late-onset schizophrenia (LOS): schizophrenia with onset between ages 40 and 60 years. New findings are presented in the context of the previous literature.
Newer studies continue to suggest that early-onset schizophrenia (EOS) and LOS share fundamental clinical features (i.e., positive symptoms, negative symptoms, functional deficits). One larger recent study confirmed earlier findings that LOS differs from EOS in several important ways, including predominance of women, lower severity of positive symptoms, and lower average antipsychotic dose requirement. However, this study did not find LOS patients were more likely to have the paranoid subtype or to have less severe negative symptoms compared with EOS patients. New neuroimaging and molecular studies are identifying possible differences in the underlying pathophysiology of EOS and schizophrenia developing in mid-life to late-life; however, more research is needed to confirm these findings and determine their significance. No studies evaluated treatment strategies specifically in LOS.
LOS continues to be an understudied area. Recent studies add support to the idea that LOS may be a distinct subtype of schizophrenia. Studies designed to elucidate the pathophysiology of LOS in comparison with EOS and to assess treatment strategies in this population are needed.
回顾近期关于迟发性精神分裂症（LOS）的文献，即发病年龄在40至60岁之间的精神分裂症。在先前文献的背景下呈现新的研究发现。
更新的研究继续表明，早发性精神分裂症（EOS）和LOS具有共同的基本临床特征（即阳性症状、阴性症状、功能缺陷）。最近一项规模较大的研究证实了早期的发现，即LOS在几个重要方面与EOS不同，包括女性占主导、阳性症状严重程度较低以及平均抗精神病药物剂量需求较低。然而，该研究并未发现与EOS患者相比，LOS患者更有可能患偏执型亚型或阴性症状较轻。新的神经影像学和分子研究正在确定EOS与中年至老年期发生的精神分裂症在潜在病理生理学方面可能存在的差异；然而，需要更多研究来证实这些发现并确定其意义。没有研究专门评估LOS的治疗策略。
LOS仍然是一个研究不足的领域。近期研究支持了LOS可能是精神分裂症一种独特亚型的观点。需要开展旨在阐明LOS与EOS相比的病理生理学并评估该人群治疗策略的研究。
