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Am J Psychiatry 1995; 152:197-207
Copyright © 1995 by American Psychiatric Association
Severity of symptoms in chronically institutionalized geriatric schizophrenic patients
M Davidson, PD Harvey, P Powchik, M Parrella, L White, HY Knobler, MF Losonczy, RS Keefe, S Katz and E Frecska
Department of Psychiatry, Mount Sinai School of Medicine, New York.
OBJECTIVE: The goal of this study was to characterize the symptoms of
geriatric, chronically ill, institutionalized schizophrenic patients and
investigate age-related differences in schizophrenic symptoms and cognitive
performance from early adulthood to late senescence. METHOD: The Positive
and Negative Syndrome Scale and the Mini-Mental State examination were used
to assess the schizophrenic symptoms and cognitive performance,
respectively, of 393 institutionalized schizophrenic patients stratified
into seven groups designated by 10- year age intervals from 25 years to
over 85 years. RESULTS: In the comparisons of the seven age groups,
significant differences between groups in positive and negative subscale
scores on the Positive and Negative Syndrome Scale and in Mini-Mental State
scores were revealed. Significant correlations between Mini-Mental State
scores and Positive and Negative Syndrome Scale negative symptom scores,
but not positive symptom scores, were found for all age groups, except for
the youngest patients studied. Current treatment with neuroleptics and
prior treatment with ECT, insulin coma, or leukotomy could not account for
the poor cognitive performance of the older schizophrenic patients.
CONCLUSIONS: The older schizophrenic patients continued to experience
psychotic and nonpsychotic symptoms in senescence. Their positive symptoms
were moderately less severe and their negative symptoms and cognitive
impairment were significantly more severe than those of the younger
patients. Somatic treatment appeared not to be responsible for the severe
cognitive impairment and negative symptoms of the older patients. These
data are relevant to chronically hospitalized geriatric schizophrenic
patients but not necessarily to all geriatric schizophrenic patients.
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