Studying late-onset schizophrenia and non schizophrenia
psychosis in elderly Egyptian patients
Hanan Hussein
a
, Ahmed El Shafei
a
, Marwa Abd El Meguid
b
, Marwa El Missiry
b
and Mahmoud Tamara
c
Departments of
a
Neuropsychiatry,
b
Neuropsychychiatry and
c
Geriatric, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
Correspondence to Marwa Abd El Meguid, MD,
Department of Psychiatry, Institute of Psychiatry, 65 El
Nozha Street, Heliopolis, Cairo, Egypt
Tel: + 002 0105752536; fax: +202 22678032;
e-mail: melmeguid@gmail.com
Received 19 May 2011
Accepted 12 August 2011
Middle East Current Psychiatry
2012, 19:12–22
Background
In Egypt, the proportion of elderly people in the population is increasing markedly;
cases of late-life psychoses are increasing at a rapid pace as the population of the
world ages, and this will create a tremendous economic burden on the society
because of the increasing rates of disability.
Aim
The aim of this work was to compare the sociodemographic and clinical
characteristics, daily living functioning, and cognitive impairment between late-onset
schizophrenia and other late-onset psychotic disorders.
Patients and methods
A cross-sectional comparative study was conducted on 100 patients: 50 patients with
schizophrenia with onset after the age of 50 years (group A) and 50 patients with
nonschizophrenia late-onset psychoses (group B). All patients were interviewed using The
Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders
Axis-I diagnosis were assessed using the Positive and Negative Syndrome Scale, the
Functional Assessment of Activity of Daily Living scale, section B of the Cambridge Mental
Disorders of the Elderly Examination, and the Wechsler Adult Intelligence Scale.
Results
Patients in group A were significantly younger – they were mainly women (72%), the
majority were never married (54%), and 62% were living alone – compared with group
B, who were mainly married (46%) and lived more often with their families. Among
patients with late onset schizophrenia spectrum, 70% had paranoid subtype, 12% had
delusional disorder and the rest had either undifferentiated or schizoaffective subtype.
On the other hand, 70% of group B patients had psychotic symptoms due to dementia,
20% had mood disorder with psychotic symptoms; and the rest 10% had psychosis
secondary to medical illnesses. (Group B) patients had significantly lower scores on
items assessing positive symptoms and higher scores on general psychopathology
than did (Group A) patients, the scores on negative symptoms, and also the total
PANSS scores were almost similar in both groups and did not show any significant
differences. Group A patients scored significantly better in daily living functioning,
whereas a significant number of patients of group B needed partial and complete
support. Cognitive assessment revealed that group A patients scored almost within
norms, except for memory, apraxia, abstract, and perception items, compared with
group B patients who scored significantly lower in all cognitive items.
Conclusion
Patients with late-onset schizophrenia compared with patients with other late-onset
psychoses differ in a number of psychosocial and clinical variables, daily functioning,
and cognitive abilities. The results of this study contribute to the development of a
better understanding of the elderly patient population with different types of late-onset
psychoses, which have been largely ignored in research.
Keywords:
activities of daily living, cognitive functions, late-onset psychoses, late-onset
schizophrenia
Middle East Curr Psychiatry 19:12–22
& 2012 Okasha Institute of Psychiatry, Ain Shams University
2090-5408
Introduction
Worldwide, the number of persons aged 65 years or older
has increased from 17 million in 1900 to 342 million in
1992 and is expected to increase to 2.5 billion (compris-
ing 20% of the total population) by 2050 [1]. In other
words, the proportion of elderly people in this population
will increase by 65%. In the next 30 years, life expectancy
12 Original article
2090-5408 & 2012 Okasha Institute of Psychiatry, Ain Shams University DOI: 10.1097/01.XME.0000407866.00571.95
Copyright © Institute of Psychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited.