Comparative Study of Clinical Features between Early- and Late-Onset Schizophrenia in South Korea

Mi-Ae Ko; Seon-Koo Lee; Jung Suk Lee

doi:10.16946/kjsr.2019.22.2.51

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Ko, Lee, and Lee: Comparative Study of Clinical Features between Early- and Late-Onset Schizophrenia in South Korea

Original Article

Korean Journal of Schizophrenia Research 2019; 22(2): 51-55.

Published online: 31 October 2019

DOI: https://doi.org/10.16946/kjsr.2019.22.2.51

Comparative Study of Clinical Features between Early- and Late-Onset Schizophrenia in South Korea

Mi-Ae Ko, MD¹, Seon-Koo Lee, MD, PhD², Jung Suk Lee, MD, PhD³

¹Department of Psychiatry, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea.

²Department of Psychiatry, Bundang Jesaeng Hospital, Seongnam, Korea.

³Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Address for correspondence: Jung Suk Lee, Department of Psychiatry, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea. Tel: 031-900-0269, Fax: 031-900-0343, thanato9@nhimc.or.k

Received 15 January 2019 Revised 20 August 2019 Accepted 10 September 2019

Korean Society for Schizophrenia Research

Abstract

Objectives

Late-onset schizophrenia (LOS, age at first onset ≥40 years) is characterized by including predominance of women, better premorbid social adjustment and lower severity of positive/negative symptoms. However, few studies have been conducted on LOS, especially in Asian countries. This study aimed to examine the clinical features of LOS in comparison with early-onset schizophrenia (EOS).

Methods

By retrospectively reviewing medical records, we assessed demographic data and clinical features of 76 LOS (20 males) and 357 EOS (144 males) who admitted to the psychiatric ward of a general hospital.

Results

The mean ages of onset were 47.3±5.1 (LOS) and 25.7±6.5 (EOS) years. There were significantly more women in LOS (73.7%) than EOS (59.6%). Significantly more LOS patients had a marital (88.2% vs. 25.8%) and employment history (28.9% vs. 13.1%) than EOS. Patients with LOS had fewer negative (14.3±9.0 vs. 19.9±9.3), general psychopathology score (36.9±11.1 vs. 42.3±13.9) than EOS patients.

Conclusion

In line with previous studies, this study demonstrated that LOS patients have better premorbid social adjustment. Our finding also replicates previous findings that LOS patients differ from EOS in predominance of women and relative lack of negative symptoms. These results suggest that LOS may be a distinct subtype of schizophrenia.

Keywords: Age of onset, Late onset, Negative symptoms, Schizophrenia, Sex ratio

Figures and Tables

Table 1

Demographic characteristics of early-onset and late-onset schizophrenia

^*: χ² test, ^†: adjusting for group differences in age

Table 2

Demographic and clinical characteristics of the group underwent intelligent test

^*: χ² test, ^†: adjusting for group differences in age, duration of illness. FIQ: Full scale Intelligence Quotient

Table 3

Clinical characteristics of early-onset and late-onset schizophrenia

^*: adjusting for group differences in age, duration of illness. PANSS: Positive and Negative Syndrome Scale, GAF: Global Assessment of Functioning

References

1. Statistics Korea. 2017 elderly people statistics. Statistics Korea;2017.

2. Hanssen M, van der, Verkaaik M, Arts B, Myin-Germeys I, van Os J, et al. Comparative study of clinical and neuropsychological characteristics between early-, late and very-late-onset schizophrenia-spectrum disorders. Am J Geriatr Psychiatry. 2015; 23:852–862.

3. Howard R, Rabins PV, Seeman MV, Jeste DV. The International Late-Onset Schizophrenia Group. Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: an international consensus. Am J Psychiatry. 2000; 157:172–178.

4. Pearlson GD, Kreger L, Rabins PV, Chase GA, Cohen B, Wirth JB, et al. A chart review study of late-onset and early-onset schizophrenia. Am J Psychiatry. 1989; 146:1568–1574.

5. Maglione JE, Thomas SE, Jeste DV. Late-onset schizophrenia: do recent studies support categorizing LOS as a subtype of schizophrenia? Curr Opin Psychiatry. 2014; 27:173.

6. Hong HS, Chae YL, Paik IH. A retrospective study on late-onset schizophrenia. J Korean Neuropsychiatr Assoc. 1991; 30:990–995.

7. Park DS, Lee YH, Choi YH, Park YS, Chung YC. Brain MRI findings for the patient with the late onset schizophrenia: comparison among patients with the early onset schizophrenia, progressive schizophrenia, senile dementia and controls. J Korean Soc Biol Psychiatry. 1997; 4:74–83.

8. Ohi K, Shimada T, Yasuyama T, Uehara T, Kawasaki Y. Variability of 128 schizophrenia-associated gene variants across distinct ethnic populations. Transl Psychiatry. 2017; 7:e988.

9. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed (DSM-IV). Washington, DC: American Psychiatric Association;1995.

10. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13:261–276.

11. Yi JS, Chung MH, Lee BW, Lee SI. Reliability and validity of the Korean version of global assessment of functioning scale. Schizophr Clin. 2003; 6:118–124.

12. Yum TH, Park YS, Oh KJ, Kim JK, Lee YH. Korean Wechsler Adult Intelligence Scale (K-WAIS) manual. Seoul: Hankook Guidance;1992.

13. Hwang ST, Kim JH, Park KB, Choi JY, Hon SW. Korean Wechsler Adult Intelligence Scale-IV administration and scoring manual. Seoul: Korea Psychology Research Institute;2012.

14. Choi WJ. A Verification of Homogeneity of K-WAIS-IV and KWAIS Intelligence Quotients: focusing on normal male and female adults in their 20s. Seoul: Duksung Women's University;2015.

15. Vahia IV, Palmer BW, Depp C, Fellows I, Gilshan S, Kraemer HC, et al. Is late-onset schizophrenia a subtype of schizophrenia? Acta Psychiatr Scand. 2010; 122:414.

16. Seeman MV. Gender differences in schizophrenia. Can J Psychiatry. 1982; 27:107–112.

17. Seeman MV. Current outcome in schizophrenia: women vs men. Acta Psychiatr Scand. 1986; 73:609–617.

18. Seeman MV. Psychopathology in women and men: focus on female hormones. Am J Psychiatry. 1997; 154:1641–1647.

19. Wong DF, Wagner HN, Dannals RF, Links JM, Frost JJ, Ravert HT, et al. Effects of age on dopamine and serotonin receptors measured by positron tomography in the living human brain. Science. 1984; 226:1393–1396.

20. Häfner H, Nowotny B, Löffler W, an der Heiden W, Maurer K. When and how does schizophrenia produce social deficits? Eur Arch Psychiatry Clin Neurosci. 1995; 246:17–28.

21. Kay SR, Lindenmayer J. Outcome predictors in acute schizophrenia: prospective significance of background and clinical dimensions. J Nerv Ment Dis. 1987; 175:152–160.

22. Zigler E, Phillips L. Social competence and outcome in psychiatric disorder. J Abnorm Soc Psychol. 1961; 63:264–271.

23. Velligan DI, Mahurin RK, Diamond PL, Hazleton BC, Eckert SL, Miller AL. The functional significance of symptomatology and cognitive function in schizophrenia. Schizophr Res. 1997; 25:21–31.

24. Velligan DI, Miller AL. Cognitive dysfunction in schizophrenia and its importance to outcome: the place of atypical antipsychotics in treatment. J Clin Psychiatry. 1999; 60:25–28.

25. Kurtz MM. Neurocognitive impairment across the lifespan in schizophrenia: an update. Schizophr Res. 2005; 74:15–26.

26. Rund BR. A review of longitudinal studies of cognitive functions in schizophrenia patients. Schizophr Bull. 1998; 24:425–435.

27. Heaton RK, Gladsjo JA, Palmer BW, Kuck J, Marcotte TD, Jeste DV. Stability and course of neuropsychological deficits in schizophrenia. Arch Gen Psychiatry. 2001; 58:24–32.

28. Heaton R, Paulsen JS, McAdams LA, Kuck J, Zisook S, Braff D, et al. Neuropsychological deficits in schizophrenics: relationship to age, chronicity, and dementia. Arch Gen Psychiatry. 1994; 51:469–476.

29. Girard C, Simard M, Noiseux R, Laplante L, Dugas M, Rousseau F, et al. Late-onset-psychosis: cognition. Int Psychogeriatr. 2011; 23:1303–1316.

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