Craig T J, Bregman Z
Department of Psychiatry and Behavioral Science, SUNY Stony Brook.
J Am Geriatr Soc. 1988 Feb;36(2):104-7. doi: 10.1111/j.1532-5415.1988.tb01777.x.
A chart review of 658 psychiatric inpatients aged 65 years or older with a clinical diagnosis of schizophrenia revealed 32 patients (4.8%) with onset of symptoms after aged 45 who met DSM-III criteria for schizophrenia (except age of onset). Clinical course and response to treatment revealed only 25% to follow an unequivocally schizophrenic pattern. Almost 20% demonstrated substantial affective symptomatology, whereas 15.6% had a brief psychotic episode with full remission, and 40.6% showed signs of organic deterioration. These results suggest that diverse underlying pathologic processes may present initially as late onset schizophreniform illness. The presence of depressive symptoms and assaultive behavior on admission predicted good treatment response while sensory deficits and development of signs of organicity were associated with poor treatment response.
对658名年龄在65岁及以上、临床诊断为精神分裂症的精神病住院患者进行的图表回顾显示，有32名患者（4.8%）在45岁以后出现症状，符合精神分裂症的DSM-III标准（除发病年龄外）。临床病程和对治疗的反应显示，只有25%的患者呈现明确的精神分裂症模式。近20%的患者表现出明显的情感症状，而15.6%的患者有短暂性精神病发作且完全缓解，40.6%的患者表现出器质性衰退的迹象。这些结果表明，多种潜在的病理过程最初可能表现为晚发性精神分裂症样疾病。入院时存在抑郁症状和攻击行为预示着治疗反应良好，而感觉缺陷和器质性体征的出现与治疗反应不佳有关。
