Advances in the Conceptualization and Study of Schizophrenia in Later Life: 2020 Update

Cohen, Carl I.; Freeman, Ksenia; Ghoneim, Dina; Vengassery, Aninditha; Ghezelaiagh, Brian; Reinhardt, Michael

doi:10.1016/j.cger.2019.11.004

Cited by 15 publications

(14 citation statements)

References 78 publications

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“…Our findings are largely consistent with recent findings that show considerable fluctuation in clinical and psychosocial parameters in the course of psychosis in later life (Cohen et al, 2020). Morgan et al (2017) have identified the following challenges for living with psychotic disorder: financial problems, loneliness, poor physical health, uncontrolled symptoms of mental illness and unstable housing.…”

Section: Discussionsupporting

confidence: 92%

“…People with a more favourable course of illness or better cognitive functioning may also cease service contact before they reach the middle age and beyond, simply because they are well or symptoms have remitted (for instance, it is estimated that 20-50% of older people with psychotic disorders achieve remission or significant improvement in symptoms; Cohen et al, 2020). In addition, some of the differences between the younger and older participants might be the normal course of ageing with a psychotic disorder -such as a gradual reduction in positive symptoms and increase in negative symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…It is also possible that the improvement in positive symptoms is attributable to better self-management and coping mechanisms (e.g. acceptance and humour; Cohen et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…It has been proposed that this paradoxical effect is more striking in people with psychotic disorders than the general population Australian & New Zealand Journal of Psychiatry, 56(1) (Jeste et al, 2011). This may be due to many older people with psychotic disorders developing better illness management through positive coping strategies and increased social support, leading to increased clinical remission, reduced relapse or hospitalisation, and enhanced self-esteem (Cohen et al, 2020). This subjective perception of ageing well in this population may also reflect an improved ability to personally engage with valued activities, to maintain positive relationships, including with the person's health care professionals, and developing a sense of acceptance of challenges and mastery over their mental illness (Smart, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Evidence describing the life circumstances and physical and psychological well-being of older people with psychotic disorders is limited (Galletly et al, 2016). Most research relating to older patients with psychosis has focused on people with late-onset disorders (Castle and Murray, 1993;Cohen et al, 2020;Vahia et al, 2010). While early intervention and youth-based psychosis paradigms are important, people who do not achieve full recovery and grow old with a psychotic disorder also deserve attention.…”

Section: Introductionmentioning

confidence: 99%

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Ageing with psychosis – Fifty and beyond

Galletly

Suetani

Hahn

et al. 2021

Aust N Z J Psychiatry

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Objective: While there is considerable current emphasis on youth and early psychosis, relatively little is known about the lives of people who live with psychotic disorders into middle age and beyond. We investigated social functioning, physical health status, substance use and psychiatric symptom profile in people with psychotic disorders aged between 50 and 65 years. Methods: Data were collected as part of the Survey of High Impact Psychosis, a population-based survey of Australians aged 18–65 years with a psychotic disorder. We compared those aged 50–65 years ( N = 347) with those aged 18–49 years ( N = 1478) across a range of measures. Results: The older group contained more women and more people with affective psychoses compared to the younger group. They were also more likely to have had a later onset and a chronic course of illness. The older group were more likely to have negative symptoms but less likely to exhibit positive symptoms; they also had lower current cognition, compared to the younger group. Compared to the younger group, the older group were more likely to be divorced/separated, to be living alone and to be unemployed. They had substantially lower lifetime use of alcohol and illicit substances, but rates of obesity, metabolic syndrome and diabetes mellitus were higher. Conclusion: Our findings suggest that the characteristics of people with psychosis change significantly as they progress into the middle age and beyond. A better understanding of these differences is important in informing targeted treatment strategies for older people living with psychosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

“…It is also possible that the improvement in positive symptoms is attributable to better self-management and coping mechanisms (e.g. acceptance and humour; Cohen et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ageing with psychosis – Fifty and beyond

Galletly

Suetani

Hahn

et al. 2021

Aust N Z J Psychiatry

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Identification of genetic features that are associated with amplitude of low‐frequency fluctuation changes in schizophrenia using omics analysis

Luo,

Du,

et al. 2024

J of Neuroscience Research

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Genetic risk for schizophrenia is thought to trigger variation in clinical features of schizophrenia, but biological processes associated with neuronal activity in brain regions remain elusive. In this study, gene expression features were mapped to various sub‐regions of the brain by integrating low‐frequency amplitude features and gene expression data from the schizophrenia brain and using gene co‐expression network analysis of the Allen Transcriptome Atlas of the human brain from six donors to identify genetic features of brain regions and important associations with neuronal features. The results indicate that changes in the dynamic amplitude of low‐frequency fluctuation (dALFF) are mainly associated with transcriptome signature factors such as cortical layer synthesis, immune response, and expanded membrane transport. Further modular disease enrichment analysis revealed that the same set of signature genes associated with dALFF levels was enriched for multiple neurological biological processes. Finally, genetic profiling of individual modules identified multiple core genes closely related to schizophrenia, also potentially associated with neuronal activity. Thus, this paper explores genetic features of brain regions in the schizophrenia closely related to low‐frequency amplitude ratio levels based on imaging genetics, which suggests structural endophenotypes associated with schizophrenia.

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