conducting re-interviews by an experienced psychia- trist to ascertain clinical relevance of psychotic symptoms using questions from the SCID. Conclusion This study fuels the ﬁnding that non-affective, non- organic psychotic symptoms arise more often in the second half of life than studies on a syndromal level have implied. LOP is less likely to be preceded by neuroticism and emotional disturbances, which sug- gests that those affected have learned to use more effective coping styles in daily life. Yet, the similarities in risk proﬁles across different ages at onset outweigh the differences. References 1. Alici-Evcimen Y, Ertan T, Eker E (2003) Case series with late- onset psychosis hospitalized in a geriatric psychiatry unit in Turkey: experience in 9 years. Int Psychogeriatr 15:69–72 2. Almeida OP (1998) Early- vs. late-onset schizophrenia: is it time to deﬁne the difference? Am J Geriatr Psychiatry 6:345–346 3. Andreasson S, Allebeck P, Engstrom A, Rydberg U (1988) Cannabis and schizophrenia. Lancet 1:1000–1001 4. Bak M, Krabbendam L, Janssen I, Graaf R, Vollebergh W, Os J (2005) Early trauma may increase the risk for psychotic expe- riences by impacting on emotional response and perception of control. Acta Psychiatr Scand 112:360–366 5. Bijl RV, van Zessen G, Ravelli A, de Rijk C, Langendoen Y (1998a) The Netherlands Mental Health Survey and Incidence Study (NEMESIS): objectives and design. Soc Psychiatry Psy- chiatr Epidemiol 33:581 6. Bijl RV, Ravelli A, van Zessen G (1998b) Prevalence of psy- chiatric disorder in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 33:587 7. Breitner JCS (2002) Paranoid psychoses in old age: much more common than previously thought? Arch Gen Psychiatry 59:60– 61 8. Castle DJ, Wessely S, Howard R, Murray RM (1997) Schizo- phrenia with the onset at the extremes of adult life. Int J Geriatr Psychiatry 12:712–717 9. Castle DJ, Murray RM (1993) The epidemiology of late-onset schizophrenia. Schizophr Bull 19:691–700 10. Christenson R, Blazer D (1984) Epidemiology of persecutory ideation in an elderly population in the community. Am J Psychiatry 141:1088–1091 11. Copeland JR, Dewey ME, Scott A, Gilmore C, Larkin BA, Cleave N, McCracken CF, McKibbin PE (1998) Schizophrenia and delusional disorder in older age: community prevalence, inci- dence, comorbidity, and outcome. Schizophr Bull 24:153–161 12. Cottler LB, Robins LN, Grant BF, Blaine J, Towle LH, Witt- chen HU, Sartorius N (1991) The CIDI-core substance abuse and dependence questions: cross-cultural and nosological is- sues. The WHO/ADAMHA Field Trial. Br J Psychiatry 159:653–658 13. Craig MC, Cutter WJ, Wickham H, Van Amelsvoort TAMJ, Rymer J, Whitehead M, Murphy DGM (2004) Effect of long- term estrogen therapy on dopaminergic responsivity in post- menopausal women—a preliminary study. Psychoneuroendo- crinology 29:1309–1316 14. Crespo-Facorro B, Piven MLS, Schultz SK (1999) Psychosis in late life: how does it ﬁt into current diagnostic criteria? Am J Psychiatry 156:624–629 293 15. Darroch J (1997) Biologic synergism and parallelism. Am J Epidemiol 145:661–668 16. De Graaf R, Bijl RV, Ravelli A, Smit F, Vollebergh WAM (2002) Predictors of ﬁrst incidence of DSM-III-R psychiatric disorders in the general population: ﬁndings from the Netherlands Mental Health Survey and Incidence Study. Acta Psychiatr Scand 106:303 17. Goldberg DP, Williams P (1988) A users guide to the General Health Questionnaire. Nelson, Windsor 18. Ha¨fner H, An der Heiden W, Behrens S, Gattaz WF, Hambrecht M, Lo¨fﬂer W, Maurer K, Munk-Jorgensen P, Nowotny B, Riecher- Ro¨ssler A, Stein A (1998) Causes and consequences of the gender difference in age at onset of schizophrenia. Schizophr Bull 24:99–113 19. Ha¨fner H (2003) Gender differences in schizophrenia. Psy- choneuroendocrinology 28:17 20. Ha¨fner H, An der Heiden W (1997) Epidemiology of schizo- phrenia. Can J Psychiatry 42:139–151 21. Hanssen M, Krabbendam L, de Graaf R, Vollebergh W, van Os J (2005a) Role of distress in delusion formation. Br J Psychiatry 187:s55–58 22. Hanssen M, Bak M, Bijl R, Vollebergh W, van Os J (2005b) The incidence and outcome of subclinical psychotic experiences in the general population. Br J Clin Psychol 44:181–191 23. Hassett A (1999) A descriptive study of ﬁrst presentation psy- chosis in old age. Aust NZ J Psychiatry 33:814–824 24. Henderson AS, Korten AE, Levings C, Jorm AF, Christensen H, Jacomb PA, Rodgers B (1998) Psychotic symptoms in the el- derly: a prospective study in a population sample. Int J Geriatr Psychiatry 13:484–492 25. Henquet C, Murray R, Linszen D, van Os J (2005) The envi- ronment and schizophrenia: the role of cannabis use. Schizophr Bull 31:608–612 26. Howard R, Castle DJ, O’Brien J, Almeida O, Levy R (1992) Permeable walls, ﬂoors, ceilings and doors. Partition delusions in late paraphrenia. Int J Geriatr Psychiatry 7:719–724 27. Howard R, Castle D, Wessely S, Murray R (1993) A comparative study of 470 cases of early-onset and late-onset schizophrenia. Br J Psychiatry 163:352–357 28. Howard R, Cox T, Almeida O, Mullen R, Graves P, Reveley A, Levy R (1995) White matter signal hyperintensities in the brains of patients with late paraphrenia and the normal, com- munity-living elderly. Biol Psychiatry 38:86–91 29. Howard R, Rabins PV, Seeman MV, Jeste DV, the International Late-Onset Schizophrenia Group (2000) Late-onset schizo- phrenia and very-late-onset schizophrenia-like psychosis: an international consensus. Am J Psychiatry 157:172–178 30. Janssen I, Krabbendam L, Bak M, Hanssen M, Vollebergh W, Graaf R, Os J (2004) Childhood abuse as a risk factor for psy- chotic experiences. Acta Psychiatr Scand 109:38–45 31. Jeste DV, Harris MJ, Pearlson GD, Rabins PV, Lesser I, Miller BL, Coles C, Yassa R (1988) Late-onset schizophrenia. Studying clinical validity. Psychiatr Clin North Am 11:1–13 32. Kay DW (1972) Schizophrenia and schizophrenia-like states in the elderly. Brit J Hosp Med 8:369–376 33. Kay DW, Cooper AF, Garside RF, Roth M (1976) The differ- entiation of paranoid from affective psychoses by patients’ premorbid characteristics. Br J Psychiatry 129:207–215 34. Krabbendam L, Janssen I, Bak M, Bijl RV, De Graaf R, Van Os J (2002) Neuroticism and low self-esteem as risk factors for psychosis. Soc Psychiatry Psychiatr Epidemiol 37:1–6 35. Krabbendam L, van Os J (2005) Affective processes in the onset and persistence of psychosis. Eur Arch Psychiatry Clin Neu- rosci 255:185–189 36. Lataster T, van Os J, Drukker M, Henquet Cc, Feron F, Gunther N, Myin-Germeys I (2006) Childhood victimisation and devel- opmental expressionof non-clinical delusional ideation and hallucinatory experiences. Soc Psychiatry Psychiatr Epidemiol 41(6):423–428 37. Lysaker PH, Wilt MA, Plascak-Hallberg CD, Brenner CA, Cle- ments CA (2003) Personality dimensions in schizophrenia: associations with symptoms and coping. J Nerv Ment Dis 191:80–86