Late-life Schizophrenia

Lee, Hee Sang

Abstract

The author attempted to study on the characteristics of schizophrenia in the elderly by reviewing the literature both on late-onset schizophrenia and early-onset schizophrenia which had extended into middle and old ages. Interest in the elderly schizophrenia has increased greatly overseas since the 1980's. In particular, elderly schizophrenia is different from those of early adulthood in regard of clinical symptoms and response to drug therapy. Therefore, a thorough understanding of the elderly schizophrenia not only helps evaluateing and treating these patients but also leads us to a more comprehensive understanding of the disease. The author reviewed the changes of concepts and etiology, clinical manifestations, prognosis, neurological features, relations to dementia, differential diagnosis with other psychiatric disorders, and drug therapy of late-life schizophrenia. The elderly schizophrenic patients differ from the young schizophrenics in regard of pharmacokinetics and pharmacodynamics. And because the elderly patients are prone to have other medical problems or adverse drug effects, clinicians should be careful in choosing which drug to use and in adjusting its dosage. Especially, due to the high risk of tardive dyskinesia when using classical antipsychotics, the study on atypical antipsychotics such as clozapine and risperidone has increased. Up to now the study on elderly schizophrenia is not sufficient in korea and needs more attention in the future.