Hostname: page-component-745bb68f8f-s22k5 Total loading time: 0 Render date: 2025-01-12T11:12:24.484Z Has data issue: false hasContentIssue false
  • English
  • Français

The Influence of Age and Sex on the Onset and Early Course of Schizophrenia

Published online by Cambridge University Press:  03 January 2018

Heinz Häfner ,
Kurt Maurer ,
Walter Löffler  and
Anita Riecher-Rössler
Heinz Häfner*
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
Kurt Maurer
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
Walter Löffler
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
Anita Riecher-Rössler
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
*
∗Prof. Dr Dr H. Häfner, Head, Central Institute of Mental Health, PO Box 12 2120, D-6800 Mannheim 1, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

A new standardised interview for the retrospective assessment of onset and early course of schizophrenia (IRAOS) was used to study the influence of age and sex on time of onset and psychopathology before first admission in 267 schizophrenic patients admitted for the first time. Mean age at onset, according to various operationalised definitions, differed by three to four years between the sexes. The age distribution at the earliest sign of mental disorder showed an early and steep increase until the age of 25 in males, and a delayed and smaller increase in females, with a second peak in women aged 45–79. Schizophrenia began with negative symptoms in 70% of cases, appearing two to six years before admission, and all positive symptoms appearing up to two years before. Both positive and negative symptoms accumulated exponentially. The early course of the disease was similar across age groups, except there was a longer period of negative symptoms before first admission in late-onset schizophrenia in women. The few significant age differences in symptoms were presumably due to general age-dependent reaction patterns like anxiety and depression or the cognitive development of personality, as indicated by an increase in fully elaborated positive symptoms, especially systematised paranoid delusions, with age.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 1 , January 1993 , pp. 80 - 86
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N. C. (1982) Negative symptoms in schizophrenia. Archives of General Psychiatry, 39, 784–788.Google Scholar
Bleuler, E. (1911) Dementia praecox oder Gruppe der Schizophrenien. In Handbuch der Psychiatrie (ed. Aschaffenburg, G.). Leipzig: Deuticke.Google Scholar
Bleuler, M. (1943) Die spätschizophrenen Krankheitsbilder. Fortschritte der Neurologie Psychiatrie, 15, 259.Google Scholar
Burke, K. C., Burke, J. D., Regier, D. A., et al (1990) Age at onset of selected mental disorders in five community populations. Archives of General Psychiatry, 47, 511–518.Google Scholar
Castle, D. J. & Murray, R. M. (1991) The neurodevelopmental basis of sex differences in schizophrenia. Psychological Medicine, 21, 565–575.CrossRefGoogle ScholarPubMed
Gross, G. (1985) Bonner Untersuchungsinstrument zur standardisierten Erhebung und Dokumentation von Basissymptomen (BSABS). In Basisstadien endogener Psychosen und das Borderline-Problem (ed. Huber, G.). Stuttgart: Schattauer.Google Scholar
Eggers, C. (1973) Verlaufsweisen kindlicher und präpuberaler Schizophrenien. Berlin: Springer.Google Scholar
Hafner, H. (1987) Epidemiology of schizophrenia. In Search for the Causes of Schizophrenia (eds Hafner, H., Gattaz, W. F. & Janzarik, W.), pp. 47–74. Berlin: Springer.CrossRefGoogle Scholar
Hafner, H., Riecher, A., Maurer, K., et al (1989) How does gender influence age at first hospitalization for schizophrenia? A transnational case register study. Psychological Medicine, 19, 903–918.CrossRefGoogle ScholarPubMed
Hafner, H., Riecher, A., Maurer, K., et al (1990) Ein Instrument zur retrospektiven Einschätzung des Erkrankungsbeginns bei Schizophrenie (Instrument for the retrospective assessment of the onset of schizophrenia – “IRAOS”) – Entwicklung und Ergebnisse. Zeitschrift für Klinische Psychologic, 19, 230–255.Google Scholar
Hafner, H. & Maurer, K. (1991) Are there two types of schizophrenia? In Negative Versus Positive Schizophrenia (eds. Marneros, A., Andreasen, N. C. & Tsuang, M. T.), pp. 134–159. Berlin: Springer.CrossRefGoogle Scholar
Hafner, H., Behrens, S., de Vry, J., et al (1991a) Oestradiol enhances the vulnerability threshold for schizophrenia in women by an early effect on dopaminergic neurotransmission. European Archives of Psychiatry and Clinical Neuroscience, 241, 65–68.Google Scholar
Hafner, H., Behrens, S., de Vry, J., et al (1991b) Warum erkranken Frauen später an Schizophrenic? Nervenheilkunde, 10, 154–163.Google Scholar
Hafner, H., Maurer, K., Löffler, W., et al (1991c) Schizophrenie und Lebensalter. Nervenarzt, 62, 536–548.Google Scholar
Hafner, H., Riecher-Rössler, A., Hambrecht, M., et al (1992) IRAOS: An instrument for the assessment of onset and early course of schizophrenia. Schizophrenia Research, 6, 209–223.Google Scholar
Harris, M. J. & Jeste, D. V. (1988) Late-onset schizophrenia: an overview. Schizophrenia Bulletin, 14, 39–55.Google Scholar
Huber, G., Gross, G. & Schüttler, R. (1979) Schizophrenic. Verlaufs- und sozial-psychiatrische Langzeituntersuchungen an den 1945 bis 1959 in Bonn hospitalisierten schizophrenen Kranken (Monographien aus dem Gesamtgebiet der Psychiatrie). Berlin: Springer.Google Scholar
Kolvin, E., Garside, R. F. & Kydd, J. S. H. (1971a) Six studies in the childhood psychoses. IV. Parental personality and attitude and childhood psychoses. British Journal of Psychiatry, 118, 403–406.CrossRefGoogle Scholar
Kolvin, E., Ounsted, C., Humphrey, M., et al (1971b) Six studies in the childhood psychoses. II. The phenomenology of childhood psychoses. British Journal of Psychiatry, 118, 385–395.Google Scholar
Kolvin, E., Ounsted, C., Richardson, L. M., et al (1971c) Six studies in the childhood psychoses III. The family and social background in childhood psychoses. British Journal of Psychiatry, 118, 396–402.CrossRefGoogle Scholar
Kolvin, E., Ounsted, C. & Roth, M. (1971d) Six studies in the childhood psychoses. V. Cerebral dysfunction and childhood psychoses. British Journal of Psychiatry, 118, 407–417.Google Scholar
Kraepelin, E. (1909–15) Psychiatrie, vols 1–4. Leipzig: Barth.Google Scholar
Langer, H., Oldigs, J. & Key, E. R. (1985) Vorstellung und Analyse einer empirisch begründeten Itemselektion von Fragebögen zur Erfassung subjektiv erlebter Störungen der Schizophrenic In Diagnostik psychischer und psychophysiologischer Störungen (eds Ebel, V. B. & Ruck, V. P.), pp. 112–153. Bonn: Deutscher Psychologen Verlag.Google Scholar
Lewine, R. J. (1988) Gender and schizophrenia. In Nosology, Epidemiology and Genetics of Schizophrenia (eds Tsuang, M. T. & Simpson, J. C.), pp. 379–397. Amsterdam: Elsevier.Google Scholar
Loranger, A. W. (1984) Sex differences in age of onset of schizophrenia. Archives of General Psychiatry, 41, 157–161.CrossRefGoogle Scholar
Maurer, K. & Hafner, H. (1991) Dependence, independence and interdependence of positive and negative symptoms. In Negative Versus Positive Schizophrenia (eds Marneros, A., Andreasen, N. C. & Tsuang, M. T.), pp. 160–182. Berlin: Springer.CrossRefGoogle Scholar
Munk-Jorgensen, P. (1986) Schizophrenia in Denmark. Incidence and utilization of psychiatric institutions. Acta Psychiatrica Scandinavica, 73, 172–180.Google Scholar
Murray, R. M., Lewis, S. W. & Reveley, A. M. (1985) Towards an aetiological classification of schizophrenia. Lancet, i, 1023–1026.Google Scholar
Remschmidt, H., Martin, M., Schulz, E., et al (1991) The concept of “positive and negative schizophrenia” in child and adolescent psychiatry. In Negative Versus Positive Schizophrenia (eds Marneros, A., Andreasen, N. C. & Tsuang, M. T.), pp. 219–242. Berlin: Springer.CrossRefGoogle Scholar
Rutter, M., Lockyer, L. & Greenfield, D. (1967) A five to fifteen-year follow-up study of infantile psychosis. II. Social and behavioural outcome. British Journal of Psychiatry, 113, 1183–1199.Google Scholar
Seeman, M. V. (1986) Current outcome in schizophrenia: women vs. men. Acta Psychiatrica Scandinavica, 73, 609–617.Google Scholar
World Health Organization (1978a) Psychiatric and Personal History Schedule, WHO 5365 MNH (19/78). Geneva: WHO.Google Scholar
World Health Organization (1978b) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
World Health Organization (1988) Psychiatric Disability Assessment Schedule (WHO/DAS). Geneva: WHO.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1973) Present State Examination (PSE). Cambridge: Cambridge University Press.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego Program. London: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.