Psychiatry Research EG

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.