THE PREVALENCE OF LATE-ONSET SCHIZOPHRENIA IN AN URBAN NURSING HOME SETTING.
Contributors: Union Institute (U.S.)
Published: 1994
Number of pages: 283
Subjects: Psychology, Clinical.; Gerontology.; Psychology, Psychobiology.; Health Sciences, Mental Health.
Description: Using the DSM-III-R criterion for Late-onset Schizophrenia (L-oS), a retrospective chart review was conducted on 146 patients in an urban nursing home setting. Four patients were identified as fitting the L-oS criteria with the onset of the schizophrenic symptoms being after 45 years of age. DSM-III-R criterias were used as a means of discerning differential diagnosis. (The DSM-III did not recognize schizophrenia after 40 years of age; DSM-III-R subtyped L-oS as schizophrenia occurring after 45 years of age; DSM-IV contains no subtype for L-oS, but also contains no age of onset barrier.).

The literature review covered an overview of primary early-onset and late-onset schizophrenia (L-oS), secondary schizophrenia, and the clinical aspects of nursing homes. Difficulties with primary versus secondary differential diagnosis of L-oS is also reviewed.

The 146 nursing home patients included 71 Black females, 42 Black males, 17 White males, and 16 White females. There were neither Hispanics, Asians, nor Native Americans present in the nursing home population.

Four suspects for L-oS were recognized: 33.3% of the schizophrenia subgroup (n = 12), 8.7% of the clinical cases (n = 46), and 2.7% of the nursing home population (n = 146). Two L-oS were diagnosed with a comorbid dementia. One L-oS was diagnosed without a comorbid dementia. Each of the 3 scored well within normal limits on cognitive testing. The fourth had never been evaluated by a psychiatrist, but showed signs of both L-oS and a severe cognitive deficit.

The investigative significance included the delineation of a previously unrecognized L-oS population, and the prevalence rate of 2.7% in an acute care nursing home setting. Findings indicated that L-oS may be underdiagnosed with some L-oS patients possibly being inappropriately housed in acute care nursing home facilities.

Many of the difficulties associated with quantitative nursing home walk-in retrospective-study research methodology were reviewed and alternative methods were suggested.

A single case study of an out-patient late-onset schizophrenic was examined in detail.
Notes: Source: Dissertation Abstracts International, Volume: 56-04, Section: B, page: 2316.

Thesis (PH.D.)--THE UNION INSTITUTE, 1994.

School code: 1033.