Older Adults with First-Onset Schizophrenia: An Under-Recognized and Under-Served Patient PopulationAuthor(s): Jessie Thuswaldner and Timothy Lau*
Schizophrenia is typically understood to be a disorder with onset in early adulthood, but nearly a quarter of patients are estimated to develop schizophrenia after age 40. Late-onset schizophrenia (patients with onset after age 40) and very-late onset schizophrenia (patients with onset after age 60) are historically an under-recognized and under-served population. Reasons for this are manifold and may include barriers such as inconsistent terminology used to describe these patients, challenges with diagnosing, and a lack of research and resources for these patients. To overcome these barriers, field studies should be conducted to determine if diagnostic manuals should include these subsets and thus provide clear diagnostic criteria. With clear criteria learning objectives could be made for medical school and residency programs which would promote the recognition of these patients. Clear diagnostic criteria would also help clinicians differentiate between onset of schizophrenia in later life and psychosis as a result of another cause such as dementia or depression. Finally, allocating funds towards research and resources in first-onset diagnosis of schizophrenia in adults over 40 would lead to the creation of evidence-based treatment guidelines for this population and allow advocacy for this poorly defined but vulnerable patient population.